Wednesday, 12 September 2012

EDI 5010 Documentation 837 Professional - Loop 2010BA Subscriber Name

2010BA Subscriber Name
 
        
 
 
In this loop, all the information will be taken from Patient Insurance(policy) information screen. Take a look of our sample screen here how patient insurance information are stored in the system.

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Now let’s start the detail implementation.
Loop Seg ID Segment Name Format Length Ref# Req Value
2010BA NM1 Subscriber Name ID 3 R NM1
Element Separator AN 1 *
NM101 Entity Identifier Code ID 2/3 98 R IL
Element Separator AN 1 *
NM102 Entity Type qualifier ID 1/1 1065 R 1
Element Separator AN 1 *
NM103 Name Last or Organization Name AN 1/60 1035 R Insured Person Last Name
Element Separator AN 1 *
NM104 Name First AN 1/35 1036 S Insured Person First Name
Element Separator AN 1 *
NM105 Name Middle AN 1/25 1037 S Insured Person Middle Name
Element Separator AN 1 *
NM106 Name Prefix AN 1/10 1038 Not used
Element Separator AN 1 *
NM107 Name Suffix AN 1/10 1039 S Insured Person Suffix
Element Separator AN 1 *
NM108 Identification code Qualifier ID 1/2 66 R MI
Element Separator AN 1 *
NM109 Identification code AN 2/80 67 R Insured Policy No
Segment Terminator ~
               
 
 
NM102 - Entity Type Qualifier
Code qualifying the type of entity
Code Definition
1 Person
2 Non-Person Entity
2010BA Subscriber Address
 
Loop Seg ID Segment Name Format Length Ref# Req Value
2010BA N3 Subscriber Address AN 2 R N3
Element Separator AN 1 *
N301 Address Line 1 AN 1/55 166 R Insured Person Address Line 1
Element Separator AN 1 *
N302 Address Line 2 AN 1/55 1065 S Insured Person Address Line 2 if exists
Segment Terminator ~

 
2010BA Subscriber City/State/Zip code
Loop Seg ID Segment Name Format Length Ref# Req Value
2010BA N4 Subscriber City / State / Zip Code AN 2 R N4
Element Separator AN 1 *
N401 City Name AN 2/30 19 R Insured Person City Name
Element Separator AN 1 *
N402 State or Province Code ID 2/2 156 R Insured Person State Code
Element Separator AN 1 *
N403 Postal Code ID 3/15 116 R Insured Person Zip Code
Segment Terminator ~



2010BA Subscriber Demographic Information.
Loop Seg ID Segment Name Format Length Ref# Req Value
2010BA DMG Subscriber Demographic ID 3 R DMG
Element Separator AN 1 *
DMG01 Date time Period Format Qualifier ID 2/3 1250 R D8
Element Separator AN 1 *
DMG02 Date time Period AN 1/35 1251 R Insured Date of birth in the Format CCYYMMDD
Element Separator AN 1 *
DMG03 Gender Code ID 1 1068 R Print M for Male
Print F for Female
Print U for unknown
Segment Terminator ~

2010BA Subscriber Name – Sample

Patient Insurance Policy Information
Field Value
Insured Last Name Balwant
Insured First Name Singal
Insured Policy Number 3A3G3343
Insured Address line 1 7508 Et, Road
Insured Address Line 2 Nullam Av
Insured City Frisco City
Insured State NY
Insured Zip Code 112348888
Insured DOB (mm/dd/yyyy) 12/11/1938
Insured Gender Female
 
NM1*IL*1*BALWANT*SINGAL****MI*3A3G3343~
N3*7508 Et, Road*Nullam Av~
N4*Frisco City*NY*112348888~
DMG*D8*19381211*F~
 
 
        

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

1 comment:

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