This is a claim level field to designate bypassing of the prior authorization processing for claims with a representative payee when an 'R' is present in the field.
Comments
This field comes from the CLM-RP-IND-CD that is present on the first claim record included in the stay. If there is no CLM-RP-IND-CD on the first claim, then take the first found code (R) on any of the other claims that make up the stay.
This field is new in 2015.
Note that there is also a Revenue Center Representative Payee (RP) Indicator Code (SAS variable called RC_RP_IND_CD).
This field comes from the CLM-RP-IND-CD that is present on the first claim record included in the stay. If there is no CLM-RP-IND-CD on the first claim, then take the first found code (R) on any of the other claims that make up the stay.
This field is new in 2015.
Note that there is also a Revenue Center Representative Payee (RP) Indicator Code (SAS variable called RC_RP_IND_CD).
Source: NCH