Submit Electronic Claims with Attachment

Claims with Attachments

Many electronic payers can 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.

About PWK

The PWK segment provides the ‘linkage’ between electronic claims and additional documentation that is needed for claim adjudication. PWK was developed to allow providers to submit additional documentation to support services billed with or at the 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, incorrect use of these codes may delay the processing of the claim as compared to a similar claim without a PWK.

Specifications for 2300 Loop -PWK Segment

The list of valid codes is available at https://www.cgsmedicare.com/jc/claims/PWK_Segment.html

To learn how to send PWK info inside claims, click here.