REF

Payer Secondary Identification

Pos: 035	Max: 3
Detail - Optional
Loop: 2010BC	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

2U

Payer Identification Number

This code can be used to identify any payer’s identification number (the payer can be Medicaid, a commercial payer, TPA, etc). Whatever number is used has been defined between trading partners.

FY

Claim Office Number

Description: The identification of the specific payer's location designated as responsible for the submitted claim

NF

National Association of Insurance Commissioners (NAIC) Code

Description: A unique number assigned to each insurance company

Code Source:

245: National Association of Insurance Commissioners (NAIC) Code

TJ

Federal Taxpayer's Identification Number

REF02

127

Reference Identification
Description: Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
Industry: Payer Additional Identifier
EMC v.6.0 Reference: Record Type 30 Field No. 5, 6 (Sequence 01-03)
Record Type 31 Field No. 15

C

AN

1/30

Required

ExternalCodeList

Name: 245

Description: National Association of Insurance Commissioners (NAIC) Code

1.

R0203 - At least one of REF02,REF03 is required

1.

REF04 contains data relating to the value cited in REF02.

Notes:

1. Required if additional identification numbers other than the primary identification number in NM108/09 in this loop are necessary to adjudicate the claim/encounter.

Example:

REF*FY*435261708~