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Back  RFI # 1570: TR3 clarification Request

Formal vs. Informal Help Informal Formal

Submitter

Regina Haley

Description

In both the 4010 and 5010 Eligibility Inquiry Transactions (270), the 2100C NM108 allows for a Member Identifier (MI) qualifier to denote what is sent in the 2100C - NM109 data element field. If the MI is a SSN and submitted in the 2100C - NM109 field, is this within the standard use of the HIPAA transaction?

Response

If the Information Source (Health Plan/Payer) utilizes the patient’s SSN as the Member ID, then it would be appropriate to identify it as the member ID and send it in 2100C NM109.
Submission 4/23/2012
Status Date 7/25/2012
Status F - Final
Primary References
Document 005010X279
Section2
Page95
Set ID270
Table2
Loop2100C
Segment Position0300
Segment IDNM1
Element Position08