Applying EOMB Codes for Billing Secondary Payers (SYSTOC_EDI)

SYSTOC has unique ways of applying EOMB codes for COB claims. There are two different methods of applying codes depending on the number of EOMB codes per line item. It is very important that the codes be entered in a specific manner so that they are included when billing the secondary payer via SYSTOC and SYSTOC_EDI.

Note: Always enter a code in the EOMB field even when the responsible party pays nothing on the line item. See Payment Denied for instructions.

Enter Claim Adjustment Group and Reason Codes to the EOMB table prior to entering receipts and adjustments. The EOMB fields are drop-down choices on the Pay Charges screen. Codes cannot be added while processing a claim. See EOMB Codes for setup instructions.