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Back  RFI # 1458: Identifying Information Source

Formal vs. Informal Help Informal Formal

Submitter

Chris Baker

Description

The 270/271 guide defines the Information Source in section 1.4.2 Basic Concepts. Does this definition require the Information Source, the entity who maintains the information regarding the patient's coverage, to be identified as such in the 2000A loop of the 271? Even if the correct Information Source was not identified in the 270?

Submitter Assigned Keywords

Information Source 2000A

Response

Yes, the Information Source must be identified in the 2000A loop of the 271. The 2000A loop represents the Information Source, that is, the entity who answers the 270 with a response if they maintain the information specific to the patient. If the Information Source identified in the 2100A of the 270 is not the correct information source, return a 2100A AAA with AAA03 = 79.

Recommendation

Validation of the Information Source should rely primarily on the identifier in the 270 2100A NM109. The idenifier to be used is in the 270 2100A NM109 typically defined in the Information Source's trading partner agreement.
Submission 11/23/2011
Status Date 1/5/2012
Status F - Final
Primary References
Document 005010X279
Section1.4.2
Set ID270