824 Application Advice (X186A1)

- This segment identifies the information about the Submitter of the 824 transaction set.

- Required when the entity identified in Loop 1000A (Submitter Name) is submitting this 824 on behalf of a sub-component, such as a branch or department within the submitter organization. If not required by this implementation guide, do not send. - This REF segment identifies the sub-component within the submitter organization, as appropriate.

- When the communication number represents a telephone number in the United States and other countries using the North American Dialing Plan (for voice, data, fax, etc.), the communication number must always include the area code and phone number using the format AAABBBCCCC where AAA is the area code, BBB is the telephone number prefix, and CCCC is the telephone number (e.g., (534) 224-2525 would be represented as 5342242525). The extension, if known, must be included in the communication number data element immediately after the telephone number. - The PER segment must be filled from left to right. PER04 must be present before PER06. The PER06 must be present before using PER08. - Only one of each type of communication number may be sent. In order to send all four types, repeat the PER segment for the fourth communication number. The PER02 must not be used in the second PER. - The second repetition of the PER must not occur unless the first is full, if the information applies to the same contact. - Required when contact information is other than indicated in the Trading Partner Agreement/profile. If not required by this implementation guide, do not send.

- This segment identifies the information about the Receiver of the 824 transaction set.

- An 824 transaction set may be used to report acceptance or rejection of an entire transaction set, an item within a transaction set, or a subordinate portion of a transaction set that contains one or more items. The OTI segment is used as the primary means to identify the portion (or all) of the received transaction set which is being reported upon. For example, if an entire transaction set (i.e. ST/SE) is being rejected, then the OTI segment would likely indicate the ST control number to identify which ST/SE transaction set of the received file is being rejected. If part of the transaction set is being rejected (e.g. a single claim status request in a 276 transaction set), then the OTI segment could indicate the Submitter Trace number in the TRN segment of the rejected portion. - When reporting with this 824 transaction set, the terms `acceptance' and `rejection' refer to edits at the application level.

- Required when additional information is necessary to identify the portion (or all) of the transaction set that is being reported in this Loop 2000 (OTI). If not required by this implementation guide, may be provided at the sender's discretion but cannot be required by the receiver. - For example, if the Loop 2000 (OTI) is being used to define a provider loop, the REF segment could be used to identify the actual provider number, indicating the specific provider loop within the transaction set. - The sender should consider `minimum necessary' privacy requirements in deciding to use this discretionary segment.

- Required when date information is necessary to identify the portion (or all) of the transaction set that is being reported in this Loop 2000 (OTI). If not required by this implementation guide, may be provided at the sender's discretion but cannot be required by the receiver. - For example, if the Loop 2000 (OTI) is being used to define a particular insurance policy, the DTM segment could be used to identify the policy effective date, helping indicate the specific policy within the transaction set.

- Required when monetary information is necessary to identify the portion (or all) of the transaction set that is being reported in this Loop 2000 (OTI). If not required by this implementation guide, may be provided at the sender's discretion but cannot be required by the receiver. - For example, if the Loop 2000 (OTI) is being used to define a premium payment, the AMT segment could be used to identify the premium amount, helping to indicate the specific premium payment within the transaction set.

- Required when quantity information is necessary to identify the portion (or all) of the transaction set that is being reported in this Loop 2000 (OTI). If not required by this implementation guide, may be provided at the sender's discretion but cannot be required by the receiver. - For example, if the LOOP 2000 (OTI) is being used to define a particular 2000 Loop in an 835 remittance advice, the QTY segment could be used to identify the total number of segments in that particular loop. This, along with corresponding REF and NM1 segments (to identify the particular provider in that loop) would help to indicate the specific 2000 Loop in that transaction set.

- Required when names are necessary to identify the portion (or all) of the transaction set that is being reported in this Loop 2000 (OTI). If not required by this implementation guide, may be provided at the sender's discretion but cannot be required by the receiver. - For example, if the Loop 2000 (OTI) is being used to define a specific dependent within an enrollment transaction set, the NM1 segment could be used to identify the specific dependent within the transaction set. - The sender should consider `minimum necessary' privacy requirements in deciding to use this discretionary segment.