EDI 270–5010 Documentation– Loop 2100C SUBSCRIBER Name

2100C Subscriber Name

        

Use this segment to identify an entity by name and/or identification number. Use this NM1 loop to identify the insured or subscriber

 

Loop	Seg ID	Segment Name	Format	Length	Ref#	Req	Value
2100C	NM1	Subscriber Name	ID	3		R	NM1
		Element Separator	AN	1			*
	NM101	Entity Identifier Code	ID	2/3	98	R	IL
		Element Separator	AN	1			*
	NM102	Entity Type qualifier	ID	1/1	1065	R	1
		Element Separator	AN	1			*
	NM103	Name Last or Organization Name	AN	1/60	1035	R	Insured Person Last Name
		Element Separator	AN	1			*
	NM104	Name First	AN	1/35	1036	S	Insured Person First Name
		Element Separator	AN	1			*
	NM105	Name Middle	AN	1/25	1037	S	Insured Person Middle Name
		Element Separator	AN	1			*
	NM106	Name Prefix	AN	1/10	1038	Not used
		Element Separator	AN	1			*
	NM107	Name Suffix	AN	1/10	1039	S	Insured Person Suffix
		Element Separator	AN	1			*
	NM108	Identification code Qualifier	ID	1/2	66	R	MI
		Element Separator	AN	1			*
	NM109	Identification code	AN	2/80	67	R	Insured Policy No
		Segment Terminator					~

 

 

NM102 - Entity Type Qualifier

Code qualifying the type of entity

Code	Definition
1	Person
2	Non-Person Entity

 

Sample
NM1*IL*1*MULLIN*DANIEL****MI*XJBH12345678~

Segment Structure

SUBSCRIBER DEMOGRAPHIC INFORMATION

Use this segment to convey the birth date or gender demographic information for the subscriber. Use this segment only if the subscriber is the patient and if this information is available from the Information Source’s database.

Loop	Seg ID	Segment Name	Format	Length	Ref#	Req	Value
2100C	DMG	Demographic Information	ID	3		S	DMG
		Element Separator	AN	1			*
	DMG01	Date Time Period format Qualifier	ID	2	1250	S	D8 = Date format
		Element Separator	AN	1			*
	DMG02	Date Time Period	AN	8	1251	S	<CCYYMMDD - Recipient Date of Birth>
		Segment Terminator					~

Sample
DMG*D8*19571112

 

 

In the PMS Software, you can fetch the information from Patient Insurance Insurer details as shown here

SUBSCRIBER VISIT DATE

Loop	Seg ID	Segment Name	Format	Length	Ref#	Req	Value
2100C	DTP	Subscriber Date	ID	3		S	DMG
		Element Separator	AN	1			*
	DTP01	Date Time Qualifier	ID	3	374	R	291=Plan
		Element Separator	AN	1			*
	DTP02	Date Time Period Format Qualifier	ID	3	1250	R	RD8=Date Format
		Element Separator	AN	1
	DTP03	Date Time Period	AN	17	1251	R	<CCYYMMDD - Recipient Date of Service> Always Current Date
		Segment Terminator					~

 

Sample
DTP*291*D8*20130829

        

 

 

Questions or feedback are always welcome. You can email me at vbsenthilinnet@gmail.com