Section title: Requests for Interpretation
RFI #
2576
Order of COB information in 834
Description

Is there a specified order in which the insurances must be presented in loop 2320 in the 834 transaction format?  Should they be in the primary, secondary, tertiary, etc. order or does it not matter?

Scenario

We have a client who is putting the secondary payer information first and the primary payer information second in the file.  The indicator is correct, but we are trying to figure out if that order is acceptable.  It is an unexpected order to us.

RFI Response

The 834 implementation guide does not specify what order multiple 2320 COB segments must be in.  It is the responsibility of the trading partners to determine what is needed for their specific business requirements.

The role of the X12 Standard is to provide the business application with the data it needs.  X12 EDI is used in multiple industries and companies, each having many business applications and practices which may or may not allow for repetitive segment qualifiers.  Therefore, there is no ‘best practice’ that pertains to the X12 Standard for repetitive segment qualifiers. 

X12 EDI allows each industry, business, trade relationship, and set of business practices to determine how repeating segments/loops should be implemented.  It is incumbent on the industry, business, and trade parties to define what is allowed or not allowed, which can be memorialized in an implementation convention that complies with X12's Intellectual Property Usage Policy.  It is the responsibility of the trading partners to determine what is appropriate for their specific business requirements and how their business applications will function.

DOCUMENT ID
005010X220