PER

Claim Contact Information

Pos: 060	Max: 3
Detail - Optional
Loop: 2100	Elements: 8

Ref

Id

Element Name

Req

Type

Min/Max

Usage

PER01

366

Contact Function Code
Description: Code identifying the major duty or responsibility of the person or group named

M

ID

2/2

Required

Code

Name

CX

Payers Claim Office

PER02

93

Name
Description: Free-form name
Industry: Claim Contact Name
Use this data element when the name of the individual to contact is not already defined or is different than the name within the prior name segment (e.g. N1 or NM1).

O

AN

1/60

Situational

PER03

365

Communication Number Qualifier
Description: Code identifying the type of communication number
Required if a contact communications number is to be transmitted.

C

ID

2/2

Situational

Code

Name

EM

Electronic Mail

FX

Facsimile

TE

Telephone

PER04

364

Communication Number
Description: Complete communications number including country or area code when applicable
Industry: Claim Contact Communications Number
Required if a contact communications number is to be transmitted.

C

AN

1/80

Situational

PER05

365

Communication Number Qualifier
Description: Code identifying the type of communication number
Required if a contact communications number is to be transmitted.

C

ID

2/2

Situational

Code

Name

EM

Electronic Mail

EX

Telephone Extension

When used, the value following this code is the extension for the preceding communications contact number.

FX

Facsimile

TE

Telephone

PER06

364

Communication Number
Description: Complete communications number including country or area code when applicable
Industry: Claim Contact Communications Number
Required if a contact communications number is to be transmitted.

C

AN

1/80

Situational

PER07

365

Communication Number Qualifier
Description: Code identifying the type of communication number
Use this code only to provide the extension for the previous communications contact number.
Required to convey a second communications contact number.

C

ID

2/2

Situational

Code

Name

EX

Telephone Extension

PER08

364

Communication Number
Description: Complete communications number including country or area code when applicable
Industry: Communication Number Extension
Use this code only to provide the extension for the previous communications contact number.
Required to convey a second communications contact number.

C

AN

1/80

Situational

1.

P0304 - If either PER03,PER04 is present, then all are required

2.

P0506 - If either PER05,PER06 is present, then all are required

3.

P0708 - If either PER07,PER08 is present, then all are required

Notes:

1. This segment should only be used when there is a claim specific communications contact instruction.
2. When the communication number represents a telephone number in the United States and other countries using the North American Dialing Plan (for voice, data, fax, etc.), the communication number should always include the area code and phone number using the format AAABBBCCCC. Where AAA is the area code, BBB is the telephone number prefix, and CCCC is the telephone number (e.g. (534)224-2525 would be represented as 5342242525). The extension, when applicable, should be included in the communication number immediately after the telephone number.
3. By definition of the standard, if PER03 is used, PER04 is required.

Example:

PER*CX**TE*8005551212~