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Back  RFI # 727: Billing Secondary 837 Claims

Formal vs. Informal Help Informal Formal

Submitter

Mary Winter

Description

When BILLING the secondary 837 claim, the payer is looking for the secondary payor information in the 2330B Loop instead of the 2010BC Loop.

Where is the proper Loop to report the secondary payor information, when billing for that secondary payor?

Submitter Assigned Keywords

BillingSecondaryPayor

Response

This question is explicitly addressed in guide 004010X096. The first paragraph in section 1.4.2.1.1 identifies that the destination payer is placed in Loop ID 2010BC. By definition, a secondary claim is going to the secondary payer, therefore that secondary payer is the destination payer and is reported in Loop ID 2010BC.

The primary payer, the payer that has already adjudicated the claim, will be reported in loop 2330B on the secondary claim.
Submission 1/27/2009
Status Date 2/4/2009
Status F - Final
Primary References
Document 004010X096
Section3.1
Page132
Set ID837
Table2
Loop2010BC
Segment PositionREF