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Back  RFI # 1184: 2010CA REF Errata 837 5010

Formal vs. Informal Help Informal Formal

Submitter

Meredith Haddock

Description

In the 837I and 837P 5010 Erratas, there is a new 2010CA-REF segment for the Property & Casualty Patient Identifier.
1) Can you provide any detail on when you would submit the "1W" Member Identification number versus the "SY" SSN?
2) Is the Member Identification Number (1W) the same value as would be sent in 2010BA-NM109 or should it be a different unique value?

Submitter Assigned Keywords

HIPAA 5010 2010CA REF Property Casualty

Response

1W, Member Identification number would be used when an identifier other than the SSN is needed to identify the patient, or in jurisdictions where the SSN is not allowed as a patient identifier. If the Patient can be identified by the value in the 2010BA NM109, then the 2010CA REF is not sent. Therefore, the value in these two segments must not be the same.

In a Worker’s Compensation scenario the 2010BA NM109 would contain the Subscriber’s Member identification number which would be the Employer’s policy number. The 2010CA REF would contain a value that specifically identifies the patient.
Submission 10/26/2010
Status Date 1/14/2011
Status F - Final
Primary References
Document 005010X222
Section837
Page19
Set ID?
Loop2010CA
Segment Position
Segment IDREF
Element Position01
Industry NameProperty and Casualty Patient ID