EDI 270–5010 Documentation–2100A Information Source Name

2100A Information Source Name

The information source is the entity who has the answer to the questions being asked in a 270 Eligibility or Benefit transaction. The information source is typically the insurer, or payer.

Use this segment to identify an entity by name and/or identification number. This NM1 loop is used to identify the eligibility or benefit information source (e.g., insurance company, HMO, IPA, employer).  

Now let’s start the detail implementation.

Loop	Seg ID	Segment Name	Format	Length	Ref#	Req	Value
Header	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 (See below for more Information)
		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

Sample
NM1*PR*2*FLORIDA BLUE*****PI*BCBSF~

Segment Structure




        

 

 

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