HL

Subscriber Hierarchical Level

Pos: 001	Max: 1
Detail - Mandatory
Loop: 2000B	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

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

O

AN

1/12

Required

HL03

735

Hierarchical Level Code
Description: Code defining the characteristic of a level in a hierarchical structure

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
The claim loop (Loop ID-2300) can be used both when HL04 has no subordinate levels (HL04 = 0) or when HL04 has subordinate levels indicated (HL04 = 1). In the first case (HL04 = 0), the subscriber is the patient and there are no dependent claims. The second case (HL04 = 1) happens when claims/encounters for both the subscriber and a dependent of theirs are being sent under the same billing provider HL (e.g., a father and son are both involved in the same automobile accident and are treated by the same provider). In that case, the subscriber HL04 = 1 because there is a dependent to this subscriber, but the 2300 loop for the subscriber/patient (father) would begin after the subscriber HL. The dependent HL (son) would then be run and the 2300 loop for the dependent/patient would be run after that HL. HL04=1 would also be used when a claim/encounter for a only a dependent is being sent.
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 insured and the patient are the same person, use this HL to identify the insured/patient, skip the subsequent (PATIENT) HL, and proceed directly to Loop ID-2300.
2. The Subscriber HL contains information about the person who is listed as the subscriber/insured for the destination payer entity (Loop ID-2010BA). The Subscriber HL contains information identifying the subscriber (Loop ID-2010BA), his or her insurance (Loop ID-2010BB), and responsible party (Loop ID-2010BC). In addition, information about the credit/debit card holder is placed in this HL (Loop ID-2010BD). The credit/debit card holder may or may not be the subscriber. See Appendix G, Credit/Debit Card Use, for a description of using Loop ID-2010BD.
3. Because this is a required segment, this is a required loop. See Appendix A for further details on ASC X12 syntax rules.
4. Receiving trading partners may have system limitations regarding the size of the transmission they can receive. The developers of this implementation guide recommend that trading partners limit the size of the transaction (ST-SE envelope) to a maximum of 5000 CLM segments. While the implementation guide sets no specific limit to the number of Subscriber Hierarchical Level loops, there is an implied maximum of 5000.

Example:

HL*2*1*22*1~