4 - 140, is the total purchased services charges. This is the total charges for all purchased services. The reason this is broken out is because not all services are considered purchased services. Just don't go looking for an explanation in the manual for why this information is needed by the insurance carrier as it has no effect oTrailer records are a subtle animal. They don't seem to do much, but in the world of medical billing and the electronic transmission of claims, trailer records can mean the difference between a whole claim file going through or being rejected like a bad virus. In this installment of our series on medical billing and electronic claims submission, we'll be continuing our review of the XA0 record, picking up with field number 18.

XA0 field 18, positions 120 - 126, is the total payer paid amount. This is the total amount of all claims being billed that have already been paid by the primary payer. For those wondering how this can even be possible, it is not uncommon for a claim to be partially paid by a payer and then rebilled by the provider in an attempt to get the outstanding balance paid off. In some cases, given the proper documentation, the remaining balance may be paid, but not often and certainly not always.

XA0 field 19, positions 127 - 133, is the total patient paid amount. This is the total amount of all claims being billed where the patient has made payments towards the claims themselves. This is mostly for the purpose of reimbursing the patient back on any claims where the services are covered. If they are not, then the patient is still responsible for the payments.

XA0 field 20, positions 134 - 140, is the total purchased services charges. This is the total charges for all purchased services. The reason this is broken out is because not all services are considered purchased services. Just don't go looking for an explanation in the manual for why this information is needed by the insurance carrier as it has no effect on

s submission, we'll be continuing our review of the XA0 record, picking up with field number 18.

XA0 field 18, positions 120 - 126, is the total payer paid amount. This is the total amount of all claims being billed that have already been paid by the primary payer. For those wondering how this can even be possible, it is not uncommon for a claim to be partially paid by a payer and then rebilled by the provider in an attempt to get the outstanding balance paid off. In some cases, given the proper documentation, the remaining balance may be paid, but not often and certainly not always.

XA0 field 19, positions 127 - 133, is the total patient paid amount. This is the total amount of all claims being billed where the patient has made payments towards the claims themselves. This is mostly for the purpose of reimbursing the patient back on any claims where the services are covered. If they are not, then the patient is still responsible for the payments.

XA0 field 20, positions 134 - 140, is the total purchased services charges. This is the total charges for all purchased services. The reason this is broken out is because not all services are considered purchased services. Just don't go looking for an explanation in the manual for why this information is needed by the insurance carrier as it has no effect o

common for a claim to be partially paid by a payer and then rebilled by the provider in an attempt to get the outstanding balance paid off. In some cases, given the proper documentation, the remaining balance may be paid, but not often and certainly not always.

XA0 field 19, positions 127 - 133, is the total patient paid amount. This is the total amount of all claims being billed where the patient has made payments towards the claims themselves. This is mostly for the purpose of reimbursing the patient back on any claims where the services are covered. If they are not, then the patient is still responsible for the payments.

XA0 field 20, positions 134 - 140, is the total purchased services charges. This is the total charges for all purchased services. The reason this is broken out is because not all services are considered purchased services. Just don't go looking for an explanation in the manual for why this information is needed by the insurance carrier as it has no effect o

This is the total amount of all claims being billed where the patient has made payments towards the claims themselves. This is mostly for the purpose of reimbursing the patient back on any claims where the services are covered. If they are not, then the patient is still responsible for the payments.

XA0 field 20, positions 134 - 140, is the total purchased services charges. This is the total charges for all purchased services. The reason this is broken out is because not all services are considered purchased services. Just don't go looking for an explanation in the manual for why this information is needed by the insurance carrier as it has no effect o

4 - 140, is the total purchased services charges. This is the total charges for all purchased services. The reason this is broken out is because not all services are considered purchased services. Just don't go looking for an explanation in the manual for why this information is needed by the insurance carrier as it has no effect on the amount that is paid on the claims themselves.

XA0 field 21, positions 141 - 156, is the provider discount information. This field is currently not supported by NSF 3.01 specifications and will not be covered in this article. Refer to your manual for an explanation of what this field is for.

XA0 field 22, positions 157 - 259, is the claim remarks field. This is another one of those fields that is rarely used, but if needed can cause lots of problems. This field is used to enter in any supportive information needed in the processing of the claims. These informational remarks must be entered in accordance with the format specified by the individual carrier being billed. Because all carriers have different requirements, it is important to check with the one you are billing to get the proper format.

XA0 field 23, positions 260 - 320, is national filler and must be filled with spaces or the entire claim file will be rejected for that particular patient. It will however, not have any effect on other patient records.

The XA0 record doesn't seem to do very much but just add up some totals, but without it, a patient's claims, up to 99 per file, will not be paid. In our next installment on medical billing we'll begin our coverage of the next in our series of trailer records, the YA0 record.