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Back  RFI # 1308: 1000 A PER segment usage TX

Formal vs. Informal Help Informal Formal

Submitter

Cheryl Atkinson

Description

The Texas DOI indicated that “the PER segment is only required to be sent in the Billing provider Loop 2010AA if it is different from the information sent in the PER segment in 1000A. When we get the claim from our clearinghouse, Loop 1000A is populated with our clearinghouse’s “EDI Submitter Info”, and we do not receive the “original” submitter Contact information.The reason for request, is that we do not want to have to publish a companion guide for this single data element, and wanted to find out exactly how this should be handled moving forward. Should we require the clearinghouse(s) to send more than one iteration of the PER segment?This could mean that there may need to be 3 iterations of the PER segment on each claim, depending upon how many entities are involved. Or,, should we simply publish a companion document requiring the Loop 2010AA Billing Provider segment be populated on the claims as well?
Thanks Cheryl Atkinson, catkinson@humana.com

Submitter Assigned Keywords

PER segment texas DOI

Response

The PER Segment in the 2010AA Loop is “Required when this information is different than that contained in the Loop ID-1000A - Submitter PER segment”. Therefore, if the Submitter is not the Billing Provider the 2010AA PER Segment is required.
Submission 4/26/2011
Status Date 6/24/2011
Status F - Final
Primary References
Document 005010X222
Section2
Page0
Set ID837P
Table1
Loop1000A
Segment IDPER
Secondary References
RFI ID 1207
Document 005010X223
Section2
Page0
Set ID837I
Table1
Loop1000A
Segment IDPER