EDI 5010 Documentation 837 Professional - Loop 2330B Other Payer Name

2330B Other Payer Name.

 

        

This loop is required only if current insurance sequence > 1. i.e. for secondary, tertiary, etc.

Say for example, if the current insurance is secondary, then we should run this loop for the primary insurance. If the current insurance is tertiary, then we should run this loop for the primary and then secondary insurance. And also so on. In general, take the sequence number of the current insurance, and run this loop for all the previous sequence insurance.

 

Loop	Seg ID	Segment Name	Format	Length	Ref#	Req	Value
2330B	NM1	Other Payer Name	ID	3		R	NM1
		Element Separator	AN	1			*
	NM101	Entity Identifier Code	ID	2/3	98	R	PR
		Element Separator	AN	1			*
	NM102	Entity Type qualifier	ID	1/1	1065	R	2
		Element Separator	AN	1			*
	NM103	Name Last or Organization Name	AN	1/60	1035	R	Insurance Name
		Element Separator	AN	1			*
	NM104	Name First	AN	1/35	1036	Not used
		Element Separator	AN	1			*
	NM105	Name Middle	AN	1/25	1037	Not Used
		Element Separator	AN	1			*
	NM106	Name Prefix	AN	1/10	1038	Not used
		Element Separator	AN	1			*
	NM107	Name Suffix	AN	1/10	1039	Not Used
		Element Separator	AN	1			*
	NM108	Identification code Qualifier	ID	1/2	66	R	PI
		Element Separator	AN	1			*
	NM109	Identification code	AN	2/80	67	R	Payer ID
		Segment Terminator					~

 

NM102 - Entity Type Qualifier

Code qualifying the type of entity

Code	Definition
1	Person
2	Non-Person Entity

 

 

Example.
SBR*P*18*******CI
AMT*D*52.01
OI***Y***Y
NM1*IL*1*Dianna*Jody****MI*XY31232
N3*4 B Blue Ridge Blvd
N4*Hamilton*OH*45011
NM1*PR*2*FLORIDA BLUE*****PI*BCBSF

 

For complete Example, please refer to use case 9 ,11, 12 in the Home page

 

 

 

 

        

Questions or feedback are always welcome. You can email me at vbsenthilinnet@gmail.com.