RFI #
1416
2320 - Other Payer Clarification
Description
In the 5010 837P/I, I am looking for a clarification on this situational rule for 2320: “Required when other payers are known to potentially be involved in paying on this claim. If not required by this implementation guide, then do not send.” If 2000B/SBR01 is not “P”, does that mean that loop 2320 is required?
RFI Response
There is no direct requirement in the 5010 TR3 to report Loop 2320 if the value in 2000B/SBR01 is not “P”. However, if the value in 2000B/SBR01 is not “P”, other payers are known to potentially be involved in paying on this claim. Therefore, when 2000B/SBR01 is not “P”, the claim must contain Loop 2320.
DOCUMENT ID
005010X222A1