RFI Browser

Back  RFI # 1933: Payer Sequencing for COB

Formal vs. Informal Help Informal Formal

Submitter

Joanmarie Cifelli

Description

This issue is related to RFI 1564 and RFI 266: In a situation in which a claim has 3 payers and the destination payer is Tertiary and the Primary and Secondary payers are the same payer (same Payer ID) how is an association built between multiple occurrences of the 2430 adjudication loops? 2430/SVD01 contains the payer ID but if the primary and secondary payers are the same how should we associate the adjudiation amounts with the primary payer and secondary payer?

Submitter Assigned Keywords

2330B and Payer Sequencing

Response

The 5010 guide does not support associating multiple occurrences of the 2430 loop where the payer ID is the same. This will be addressed in a future version of the guide.

Recommendation

Submitter can add a suffix or prefix to one of the payer IDs to make them unique. This change must be done in both the 2320 and 2430 loops.
Submission 5/9/2014
Status Date 7/29/2014
Status F - Final
Primary References
Document 005010X222
Section1.4.3.1
Loop2330B