Section title: Requests for Interpretation
RFI #
2356
Multiple TRN
Description

When returning a 271 for a member with multiple active policies, we send each policy in a separate HL segment. Since the second policy is a completely separate HL segment we have been returning the TRN segment again with the second policy. How are others interpreting that the TRNs should be returned?

Response

The use of separate HLs is not appropriate. The TRN from the 270 would then be returned in the 2100C/D loop where the 2110C/D loops and 2120C/D loops (if applicable) are returned. Per 1.4.7.1, item number 6, where it states ”6. Other payers or plans if known in 2120C/D. (Note: Do not return details of coverage or benefits associated with other payers or plans, the Information Receiver should initiate a separate 270 request to the other payer or plan to determine the level of coverage). Therefore, if the subscriber ID is the same for each policy, the policies should be listed via multiple 2110C/D loops. If the subscriber ID is different for each policy, the indication the subscriber has multiple coverages should be returned, the 2120C/D loop identifying the information to have the provider submit the 270 to the payer with the information returned on the first 271.

DOCUMENT ID
005010X279