EDI 5010 Documentation 837 Professional - Loop 2010BB Payer Name

2010BB Payer Name
        

In this loop, all the information will be taken from Insurance master screen. Take a look of our sample screen here how 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
2010BB NM1 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
2010BB Payer Address

Loop Seg ID Segment Name Format Length Ref# Req Value
2010BB N3 Payer Address AN 2 R N3
Element Separator AN 1 *
N301 Address Line 1 AN 1/55 166 R Insurance Address 1
Element Separator AN 1 *
N302 Address Line 2 AN 1/55 1065 S Insurance Address Line 2 if exists
Segment Terminator ~

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


2010BB Payer Name – Sample
Insurance Master Information.
Field Value
Insurance Name CIGNA
Insurance Payer ID 9086
Insurance Address line 1 PO BOX 5200
Insurance Address Line 2
Insurance City Scranton
Insurance State PA
Insurance Zip Code 185051111

NM1*PR*2*AETNA HEALTH INC*****PI*9393~
N3*P.O. BOX 1125~
N4*Blue Bell*PA*19422~
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