EDI 5010 Documentation 837 Professional - Loop 2010BB Payer Name

2010BB Payer Name

        

In this loop, all the information will be taken from Insurance master screen. Take a look of our sample screen here how insurance information are stored in the system.

Now let’s start the detail implementation.

Loop	Seg ID	Segment Name	Format	Length	Ref#	Req	Value
2010BB	NM1	Payer Name	ID	3		R	NM1
		Element Separator	AN	1			*
	NM101	Entity Identifier Code	ID	2/3	98	R	PR
		Element Separator	AN	1			*
	NM102	Entity Type qualifier	ID	1/1	1065	R	2
		Element Separator	AN	1			*
	NM103	Name Last or Organization Name	AN	1/60	1035	R	Insurance Name
		Element Separator	AN	1			*
	NM104	Name First	AN	1/35	1036	Not used
		Element Separator	AN	1			*
	NM105	Name Middle	AN	1/25	1037	Not Used
		Element Separator	AN	1			*
	NM106	Name Prefix	AN	1/10	1038	Not used
		Element Separator	AN	1			*
	NM107	Name Suffix	AN	1/10	1039	Not Used
		Element Separator	AN	1			*
	NM108	Identification code Qualifier	ID	1/2	66	R	PI
		Element Separator	AN	1			*
	NM109	Identification code	AN	2/80	67	R	Payer ID
		Segment Terminator					~

 

NM102 - Entity Type Qualifier

Code qualifying the type of entity

Code	Definition
1	Person
2	Non-Person Entity

2010BB Payer Address

Loop	Seg ID	Segment Name	Format	Length	Ref#	Req	Value
2010BB	N3	Payer Address	AN	2		R	N3
		Element Separator	AN	1			*
	N301	Address Line 1	AN	1/55	166	R	Insurance Address 1
		Element Separator	AN	1			*
	N302	Address Line 2	AN	1/55	1065	S	Insurance Address Line 2 if exists
		Segment Terminator					~

2010BB Payer City/State/Zip code

Loop	Seg ID	Segment Name	Format	Length	Ref#	Req	Value
2010BB	N4	Payer City / State / Zip Code	AN	2		R	N4
		Element Separator	AN	1			*
	N401	City Name	AN	2/30	19	R	Insurance City Name
		Element Separator	AN	1			*
	N402	State or Province Code	ID	2/2	156	R	Insurance State Code
		Element Separator	AN	1			*
	N403	Postal Code	ID	3/15	116	R	Insurance Zip Code
		Segment Terminator					~

2010BB Payer Name – Sample

Insurance Master Information.

Field	Value
Insurance Name	CIGNA
Insurance Payer ID	9086
Insurance Address line 1	PO BOX 5200
Insurance Address Line 2
Insurance City	Scranton
Insurance State	PA
Insurance Zip Code	185051111

 

NM1*PR*2*AETNA HEALTH INC*****PI*9393~
N3*P.O. BOX 1125~
N4*Blue Bell*PA*19422~

 

 

        

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