Section title: Requests for Interpretation
RFI #
1933
Payer Sequencing for COB
Description

This issue is related to RFI 1564: 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?

RFI 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.

RFI 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.

DOCUMENT ID
005010X222