REF

Additional Coordination of Benefits Identifiers

Pos: 405	Max: 5
Detail - Optional
Loop: 2320	Elements: 2

Ref

Id

Element Name

Req

Type

Min/Max

Usage

REF01

128

Reference Identification Qualifier
Description: Code qualifying the Reference Identification

M

ID

2/3

Required

Code

Name

60

Account Suffix Code

6P

Group Number

A6

Employee Identification Number

SY

Social Security Number

The social security number may not be used for any Federally administered programs such as Medicare or CHAMPUS.

ZZ

Mutually Defined

Mutually Defined, will be used in this REF01 for National Individual Identifier until a standard code is defined.

REF02

127

Reference Identification
Description: Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
Industry: Insured Group or Policy Number

C

AN

1/30

Required

1.

R0203 - At least one of REF02,REF03 is required

1.

REF04 contains data relating to the value cited in REF02.

Notes:

1. This segment should be sent if additional data on coordination of benefits exists.
2. This segment should be sent if supplied by the subscriber. Use the Social Security Number or Employee ID Number until the National ID Number for individuals is available.

Example:

REF*6P*AZ12345~