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Back  RFI # 176: 271 Eligibility Response

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Submitter

Cindy Hardel

Description

It there a requirement in the 271 IG that the Subscriber Benefit Related Entity Identification number (2120C NM109) should not match the Information Source Identification number (2100A NM109)

Submitter Assigned Keywords

271

Response

The 2120 loop is used to identify an entity directly related to the benefit identified in the 2110 loop. The Information Source identified in 2100A would already be associated with all benefits identified in 2110 by virtue of the structure of the 271 transaction. IG 004010X092 2120C NM1 segment note on page 250 states “This NM1 loop is used to identify ... another information source when applicable to the eligibility response."

In the event that the Information Source needed to identify different address (N3 and N4) or contact (PER) information than that identified in 2100A loop, then use of the 2120 loop with the same value in 2100A NM109 and 2120C NM109 would be allowed as it would identify “another information source”.

If the address or contact information in 2100A is either the same as or not present in the 2120 loop, the use of the 2120 loop would violate the 2120 NM1 segment note since it would not be identifying “another information source” and in this case the 2120 loop must not be sent.
Submission 1/12/2005
Status Date 5/9/2005
Status F - Final
Primary References
Document 004010X92A1
SectionSegment
Page163
Set ID271
Table2
Loop2100A
Segment Position030
Segment IDNM1
Element Position67
Industry NameInformation Source Primary Id
Secondary References
RFI ID 143
Document 004010X092A1
SectionSegment
Page250
Set ID271
Table2
Loop2120C
Segment Position340
Segment IDNM1
Element Position67
Industry NameBenefit Related Entity Identification