Claims with Attachments
Many electronic payers are able to receive and use Supplemental Information through the Paperwork(PWK) segment as defined in the Health Care Claim 837 Implementation Guide. This segment contains paperwork codes to indicate documents available to the payer if needed.
The PWK segment provides the ‘linkage’ between electronic claims and additional documentation which is needed for claims adjudication. PWK was developed to allow providers to submit additional documentation to support services billed with or at time of claim submission. PWK indicators are submitted directly on the electronic claim. They are designed to notify the payer that additional documentation will be submitted to support the billing/services of the claims.
a. The PWK segment and attachments should only be used when supplemental information is necessary for the claim to be accurately and completely adjudicated according to established policies.
b. If the documentation is needed for adjudication, payers will contact you and request a faxed copy.
c. The specific paperwork codes in the PWK segment will trigger processors to consider the contents of the supplemental information obtained via fax. Therefore, use of these codes incorrectly may delay the processing of the claim as compared to a like claim without a PWK.
Specifications for 2300 Loop -PWK Segment
|PWK 01||Report Type Code||
|PWK 02||Report Transmission Code||
|PWK 06||Attachment Control number(if applicable)|
|PWK 07||Description(Optional- UB claims only)|
The list of valid codes are available at https://www.cgsmedicare.com/jc/claims/PWK_Segment.html
How to Enter PWK Info in PracticeSuite
- Go to Patient Demographics->Case-> ‘Others’ tab-> “Attachment Information”.
- Enter attachment information; the fields in the Attachment Information section are mapped to PWK segment in electronic claims; see Image 1.
|Control Number||A reference number of the document if applicable|
|Type Code||The codes and descriptions are available at http://www.cgsmedicare.com/jc/claims/PWK_Segment.html|
|Transmission Code||FX indicates Fax|