If you've been following our series on medical billing and more specifically, our series on electronic billing of claims using NSF 3.01 specifications, you have no doubt noticed that there are quite a few records involved with sending a claim to a carrier, whether it be Medicare, Medicaid, or a private insurance company. Well, before we go into explicit detail on the trailer record specifications themselves, a general overview of trailer records is probably in order.
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Why? Well, unfortunately, even if the individual claims in a submission are clean, meaning no errors or violations, a problem with any of the trailer records can get not just one, but ALL the claims rejected.
The individual records, or claims in a claims file, need to have all the individual I's dotted and T's crossed. But still, that isn't enough. Because all of those individual claims need to be totaled up. In other words, if the sum amount of all your claims comes out to $759.83, then your total record better show $759.83 in total claims and not $759.84. Just one penny off in your totals record and your whole batch, not just one claim, will be rejected.
Totals of dollars are not the only thing that has to be just right. The trailer, or totals records, count up a lot of other things as well. One of the main things that are counted in the trailer records is the actual number, not only of claims but of records themselves.