HL

Subscriber Level

Pos: 010	Max: 1
Detail - Mandatory
Loop: 2000C	Elements: 4

Ref

Id

Element Name

Req

Type

Min/Max

Usage

HL01

628

Hierarchical ID Number
Description: A unique number assigned by the sender to identify a particular data segment in a hierarchical structure
Use this sequentially assigned positive number to identify each specific occurrence of an HL segment within a transaction set. It should begin with the number one and be incremented by one for each successive occurrence of the HL segment within that specific transaction set (ST through SE).
An example of the use of the HL segment and this data element is:
HL*1**20*1~
NM1*PR*2*ABC INSURANCE COMPANY*****PI*842610001~
HL*2*1*21*1~
NM1*1P*1*JONES*MARCUS***MD*SV*0202034~
HL*3*2*22*1~
NM1*IL*1*SMITH*ROBERT*B***MI*11122333301~
HL*4*3*23*0~
NM1*03*1*SMITH*MARY*LOU~
Eligibility/Benefit Data
HL*5*2*22*0~
NM1*IL*1*BROWN*JOHN*E***MI*22211333301~
Eligibility/Benefit Data

M

AN

1/12

Required

HL02

734

Hierarchical Parent ID Number
Description: Identification number of the next higher hierarchical data segment that the data segment being described is subordinate to
Use this code to identify the specific hierarchical level to which this level is subordinate.

O

AN

1/12

Required

HL03

735

Hierarchical Level Code
Description: Code defining the characteristic of a level in a hierarchical structure
All data that follows an HL segment is associated with the entity identified by the level code; this association continues until the next occurrence of an HL segment.

M

ID

1/2

Required

Code

Name

22

Subscriber

HL04

736

Hierarchical Child Code
Description: Code indicating if there are hierarchical child data segments subordinate to the level being described
Use this code to indicate whether there are additional hierarchical levels subordinate to the current hierarchical level.
If there is a Loop 2000D (Dependent) level subordinate to the current Loop 2000C, the value will be “1". If there is no Loop 2000D (Dependent) level subordinate to the current Loop 2000C, the value will be ”0" (zero).
All valid standard codes are used.

O

ID

1/1

Required

1.

The HL segment is used to identify levels of detail information using a hierarchical structure, such as relating line-item data to shipment data, and packaging data to line-item data.

2.

The HL segment defines a top-down/left-right ordered structure.

3.

HL01 shall contain a unique alphanumeric number for each occurrence of the HL segment in the transaction set. For example, HL01 could be used to indicate the number of occurrences of the HL segment, in which case the value of HL01 would be "1" for the initial HL segment and would be incremented by one in each subsequent HL segment within the transaction.

4.

HL02 identifies the hierarchical ID number of the HL segment to which the current HL segment is subordinate.

5.

HL03 indicates the context of the series of segments following the current HL segment up to the next occurrence of an HL segment in the transaction. For example, HL03 is used to indicate that subsequent segments in the HL loop form a logical grouping of data referring to shipment, order, or item-level information.

6.

HL04 indicates whether or not there are subordinate (or child) HL segments related to the current HL segment.

Notes:

1. If the transaction set is to be used in a real time mode (see section 1.3.2 for additional detail), it is required that the 270 transaction contain only one patient request. One patient is defined as either, one subscriber loop if the member is the patient, or one dependent loop if the dependent is the patient.
If the transaction set is to be used in a batch mode (see section 1.3.2 for additional detail), it is required that the 270 transaction contain a maximum of ninety-nine patient requests. Each patient is defined as either, one subscriber loop if the member is the patient, or one subscriber loop and one dependent loop if the dependent is the patient.
Although it is not recommended, if the number of patients is to be greater than one for real time mode or greater than ninety-nine for batch mode, the trading partners (the Information Source, the Information Receiver and the switch the transaction is routed through, if there is one involved) must all agree to exceed the number of patient requests and agree to a reasonable limit.
2. Use this segment to identify the hierarchical or entity level of information being conveyed. The HL structure allows for the efficient nesting of related occurrences of information. The developers’ intent is to clearly identify the relationship of the patient to the subscriber and the subscriber to the provider.
Additionally, multiple subscribers and/or dependents (i.e., the patient) can be grouped together under the same provider or the information for multiple providers or information receivers can be grouped together for the same payer or information source.
3. An example of the overall structure of the transaction set when used in batch mode is:
Information Source (Loop 2000A)
Information Receiver (Loop 2000B)
Subscriber (Loop 2000C)
Dependent (Loop 2000D)
Eligibility or Benefit Inquiry
Dependent (Loop 2000D)
Eligibility or Benefit Inquiry
Subscriber (Loop 2000C)
Eligibility or Benefit Inquiry

Example:

HL*3*2*22*1~