Claim edit: Service date outside the statement covers period
Stedi now rejects 837I institutional claims with a service line date outside the claim's statement covers period.
Statement covers periods and service dates
An institutional claim can bill for a range of dates. This range is called the statement covers period. You report the statement covers period at the claim level.
Statement covers period
| Claim type | JSON API field | X12 element |
|---|---|---|
| 837I institutional | claimInformation.claimDateInformation.statementBeginDate and claimInformation.claimDateInformation.statementEndDate | DTP*434 (Statement Dates) of Loop 2300 (Claim Information) |
Service lines can also carry their own service dates. X12 standards require service dates on outpatient service lines when the statement covers period is longer than one day.
Service date
| Claim type | JSON API field | X12 element |
|---|---|---|
| 837I institutional | claimInformation.serviceLines.serviceDate and claimInformation.serviceLines.serviceDateEnd | DTP*472 (Service Date) of Loop 2400 (Service Line) |
How the edit works
Each service date on a claim must fall within the statement covers period. If you include a service date outside the statement covers period, the payer may reject the claim.
This edit catches the issue before the claim reaches the payer. It prevents payer rejections, which take longer to resolve and delay payment for the provider.
Rejection errors
If you submit a claim using Stedi's Claim Submission API endpoints and the claim fails the edit, you'll get back an error response in real time. The response includes details in the errors array:
{
"errors": [
{
"code": "33",
"description": "Invalid Service Date. The service date must fall within the claim's statement dates. The service date, 20241020-20241020, on line 1 falls outside the claim's statement dates of 20241015-20241017. Correct and resubmit.",
"followupAction": "Please Correct and Resubmit"
}
]
}If you submit a claim using SFTP and the claim fails the edit, Stedi will reject the claim with a 277CA claim acknowledgment. The acknowledgment will include a related claim status category code, claim status code, and error message:
STC*A7>187**U*******A8>188**Invalid Service Date. The service date must fall within the claim's statement dates. The service date, 20241020-20241020, on line 1 falls outside the claim's statement dates of 20241015-20241017. Correct and resubmit.~Resolution tips
You have two ways to fix the claim:
-
Widen the statement covers period. Change the begin or end date so it includes the service date.
-
Split the claim. Move the service line to its own claim, with a statement covers period that includes the service date.
Related claim edits
Stedi has another edit for date ranges that start after they end. See Invalid date range.