RFI #
1797
835 Rendering Provider
Description
If an 837 Institutional claim is received with a Rendering Provider and that Provider is stored in the system, but is not used by the system to adjudicate the claim, does that Rendering Provider need to be returned on the 835 for that claim.
RFI Response
The Situational Rule of the Service Provider Name segment reads: "Required when the Rendering Provider is different than the payee. If not required by this implementation guide, do not send." If the Rendering Provider is different than the payee, then it is required to be sent in the 835. If the Rendering Provider is the same as the payee, then the Rendering Provider must not be sent.
DOCUMENT ID
005010X221