In the 5010 TR3 there is a new DTM segment referred to as Claim Received Date. The situational rule indicates it is a required segment when state or federal regulations or the provider contract mandate interest payments or prompt payment discounts based on the receipt date of the claim by the payer. In the DTM02 data element, the note indicates that this data element is the date that the claim was received by the payer.
While AZ Medicaid has such a regulation, it is not based on the receipt date of the claim but rather a clean claim date. The providers may have to provide additional information before the clean claim date can be established; therefore, the receipt date and clean claim date can be two different dates. How would you suggest using this new segment when the dates are different?
While the separate iteration of the REF segment for the Claim Received Date is new, the usage is not new. Version 4010 included the same DTM01 qualifier as part of the Claim Date DTM segment. The usage of the segment is explicitly for the date that the claim was received by the payer. There is no support for the date that the claim is considered to be clean by the payer