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Back  RFI # 1661: 271 TRN for dependent

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Submitter

Julia Dunicheva

Description

270 request comes in for the dependent and it has TRN assigned.
Payer does not find the subscriber and returns AAA in 2100C loop.
Should payer return 2000D loop with TRN for depdent in such case? or is it compliant with the IG not to return 2000D loop at all in this case?

Submitter Assigned Keywords

TRN 271

Response

The 005010X279/005010X279A1 TR3/errata Section 1.4.6.1 Information Receiver (which outline linkage available to the Information Receiver) states “TRN segments in either Loop 2000C or Loop 2000D, whichever is the patient. The information receiver may create one occurrence of the TRN segment at the lower of these levels. These segments are optional for the information receiver, however if the information source receives them, they must be returned in the 271 response transaction unless a AAA is generated in 2000A, 2100A or 2100B.” Since the subscriber identified in 2100C was not found and a AAA would be returned in the 2100C loop, the 2000D TRN, if sent on the 270, must be returned in the 271 2000D loop. The 2100D NM1 segment as valued in the 270 request must also be returned in the 271as well as the 2100D DMG segment if it was present in the 270 request as well.

It would not be compliant with the requirements of the 005010X279/005010X279A1 TR3/errata to not return the 2000D and 2100D loops when there is an AAA segment returned in the 2100C loop in the case outlined in the description.
Submission 8/13/2012
Status Date 11/13/2012
Status F - Final
Primary References
Document 005010X279
Section2.4
Set ID271
Loop2000D