EDI 270–5010 Documentation–2100A Information Source Name

2100A Information Source Name

The information source is the entity who has the answer to the questions being asked in a 270 Eligibility or Benefit transaction. The information source is typically the insurer, or payer.

Use this segment to identify an entity by name and/or identification number. This NM1 loop is used to identify the eligibility or benefit information source (e.g., insurance company, HMO, IPA, employer).  

Now let’s start the detail implementation.
Loop Seg ID Segment Name Format Length Ref# Req Value
Header 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 (See below for more Information)
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

Sample
NM1*PR*2*FLORIDA BLUE*****PI*BCBSF~

Segment Structure

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