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Back  RFI # 279: non-destination provider #s

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Submitter

Dyan Anderson

Description

Problem with reporting a hospital's non-destination provider#s. We are reporting the NM1*85 and up to 8 REF segments for every 837I claim in a batch at the 2010AA loop for hospital's dest. provider # & all non-dest. payers. We have not had any problems with this reporting structure except for one CH import file, which only reads the 1st REF segmt at the 2010AA loop for the provider # of the dest.payer. They are looking for the additional non-dest. provider#s for the hospital to be reported in the 2330H Loop.

Per IG, when send the 2330H Loop, we must send the 2310E Loop. We can't send the 2310E Loop in the 837I for our claims as the 2010AA Billing Provider is always the same as the Service Facility (i.e., the hospital).

How are non-dest. provider#s for hospital to be reported in 837I?

Submitter Assigned Keywords

non-destination provider#s 2310E 2330H

Response

See page 32, Section 2.2 Loop Labeling and Use of the implementation guide for the 837 Institutional Claim (004010X096)

Translators should distinguish between equivalent subloops and segments by qualifier codes (e.g., the value carried in NM101 in loops 2010BA, 2010 BB,
and 2010BC; the values in the DTP01s in the 2300 loop), not by the position of the subloop or segment in the transaction. The number of times a loop or
segment can be repeated is indicated in the detail information on that portion of the transaction.
Submission 7/8/2005
Status Date 9/16/2005
Status F - Final
Primary References
Document 004010X096A1
Sectionunknwn
Page82
Set ID837I
Loop2330H
Segment IDREF