COB Coordination of Benefits

Batch

To supply information on coordination of benefits

Elements

PositionElementNameTypeMin/MaxRepeat
11138Payer Responsibility Sequence Number CodeOptID1/11
2127Reference IdentificationOptAlphanumeric1/801
31143Coordination of Benefits CodeOptID1/11
41365Service Type CodeOptID1/29

Element Details

ID1138
NamePayer Responsibility Sequence Number Code
LengthMin 1 / Max 1
Position1
RequirementOpt
Codes
  • <>G
    Payer Responsibility Ten
  • <>P
    Primary
  • <>N
    Unconfirmed
  • <>A
    Payer Responsibility Four
  • <>D
    Payer Responsibility Seven
  • <>T
    Tertiary
  • <>O
    Noncapitated Agreement
  • <>B
    Payer Responsibility Five
  • <>R
    Non-specified
  • <>E
    Payer Responsibility Eight
  • <>U
    Unknown
  • <>H
    Payer Responsibility Eleven
  • <>C
    Payer Responsibility Six
  • <>S
    Secondary
  • <>F
    Payer Responsibility Nine