Intellect TM
Reading and Understanding the 999 Report
(2012)
In this Topic Hide
What is the 999 Report and Why is it Important?
When is the 999 Report Available?
What do I do if the 999 Report is Rejected?
Unix: How do I match the 999 Report to the Electronic Claim Report?
Intellect: How do I match the 999 Report to the Electronic Billing Report?
The 999 Report is a report generated by Medicare which contains the results, ‘A’ccepted or ‘R’ejected, of the first level edit all electronically billed claims go through. It is important because only ‘A’ccepted claims will continue on to the second level edit which results in an Acknowledgement Report.
The 999 Report will indicate whether your claims were ‘A’ccepted or ‘R’ejected by the letter on the AK9 segment or line (or IK5 segment or line). If your transmission is ‘R’ejected the entire batch of claims is rejected.
‘A’ccepted: IK5*A
AK9*A*1*1*1
‘R’ejected: IK5*R*I5
AK9*R*1*1*0
EXAMPLE: You transmitted 100 claims and the 999 Report finds an error with 1 of the claims. This results in the entire batch of 100 claims being rejected, not just the 1 claim with the error(s).
The 999 Report below indicates that the transmission was ‘R’ejected.
UNIX:
ISA*00* *00* *27*01192 *27*000000111 *120125*011
GS*FA*01192*000000111*20120125*01135901*648218*X*005010X231A1
ST*999*648218001*005010X231A1
AK1*HC*1*005010X222A1
AK2*837*0048800*005010X222A1
IK3*N4*2414*2330*8
CTX*CLM01:0339507
IK4*4**2
CTX*SITUATIONAL TRIGGER*N4*2414*2330*4
IK5*R*I5
AK9*R*1*1*0
SE*10*648218001
GE*1*648218
IEA*1*000660706
INTELLECT:
Version 9.12.28 and prior, or in Misc/View 997
ISA*00* *00* *27*01192 *27*000000111 *120125*011
GS*FA*01192*000000111*20120125*01135901*648218*X*005010X231A1
ST*999*648218001*005010X231A1
AK1*HC*48799*005010X222A1
AK2*837*48800*005010X222A1
IK3*N4*2414*2330*8
CTX*CLM01:0339507
IK4*4**2
CTX*SITUATIONAL TRIGGER*N4*2414*2330*4
IK5*R*I5
AK9*R*1*1*0
SE*10*648218001
GE*1*648218
IEA*1*000660706
Effective Version 9.12.29
The 999 Report below indicates that the transmission was ‘A’ccepted.
UNIX:
ISA*00* *00* *27*01192 *27*000000111 *120125*011
GS*FA*01192*000000111*20120125*01135901*648218*X*005010X231A1
ST*999*648218001*005010X231A1
AK1*HC*1*005010X222A1
AK2*837*0048800*005010X222A1
IK5*A
AK9*A*1*1*1
SE*10*648218001
GE*1*648218
IEA*1*000660706
INTELLECT:
ISA*00* *00* *27*01192 *27*000000111 *120125*011
GS*FA*01192*000000111*20120125*01135901*648218*X*005010X231A1
ST*999*648218001*005010X231A1
AK1*HC*48799*005010X222A1
AK2*837*0048800*005010X222A1
IK5*A
AK9*A*1*1*1
SE*10*648218001
GE*1*648218
IEA*1*000660706
Manually transmitted claims (successful): UNIX
The report will be available for you to download immediately after you receive the Electronic Claim Report.
Manually transmitted claims (successful): INTELLECT
The report will be available for you to download immediately after you receive the Electronic Billing Report.
Automatically transmitted claims (successful): UNIX
The report should be in your printer for review the following day.
Automatically transmitted claims (successful): INTELLECT
The file will be available to view under Billing/TeleCom/Acknowledgement
UNIX:
1) Compare your 999 ‘R’ejection with the sample ‘R’ejections below for self-resolution. Correct the error(s) and rebill ALL the claims on your Electronic Claim Report.
2) Check our website
3) Email your 999 Report to ansi5010@primeclinical.com. To expedite a reply, be sure to include your client id, contact name, contact phone # and extension, and clinic #.
4) Fax the information to (626) 449-5615
INTELLECT:
1)Compare your 999 ‘R’ejection with the sample ‘R’ejections below for self-resolution.
Correct the error(s) and rebill ALL the claims on your Electronic Billing Report.
2) Check our website
3) Email your 999 Report to ansi5010@primeclinical.com. To expedite a reply, be sure to include your client id, contact name, contact phone # and extension, and clinic #.
4) Fax the information to (626) 449-5615
The last line of the Electronic Claim Report should read similarly as follows:
Unique Transmission Number in ISA Segment: ---> 48799
Successfully Connected to the remote system:
------------------------------------------------------------------------------------
Referring to the following line from the sample 999 Report above:
AK2*837*0048800*005010X222A1
take the third entry on this line, all entries being separated by an asterisk (*), and subtract 1. If this number matches the Unique Transmission Number in ISA Segment then this 999 Report is the one associated with this Electronic Claim Report,i.e., 48800 - 1 = 48799.
The last line of the Electronic Billing Report should read similarly as follows:
File: E:\home\staff\EB\1-3-9-2012-22-40-25.1 Claim count: …. Reference Number: 48799
--------------------------------------------------------------------------------------------------------------------------------
Referring to the following line from the sample 999 Report above:
AK1*HC*48799*005010X222A1
Look at the third entry on this line, all entries being separated by an asterisk (*). If this number matches the Reference Number: 48799 then this 999 Report is the one associated with this Electronic Billing Report. i.e., 48799 = 48799.