Thursday, 20 September 2012

EDI 5010 Documentation 837 Professional - Loop 2330A Other Subscriber Name

2330A Other Subscriber 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.


Now let’s start the detail implementation.
Loop Seg ID Segment Name Format Length Ref# Req Value
2330A NM1 Other 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
 
2330A Other Subscriber Address
 
Loop Seg ID Segment Name Format Length Ref# Req Value
2330A 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 ~

2330A Other Subscriber City/State/Zip code
Loop Seg ID Segment Name Format Length Ref# Req Value
2330A 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 ~
 

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

 

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. 

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