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Data Element Name:  Payer Identification Number File Location:  Master, De-Identified
SPARCS Data Element Number:  40
Record Positions:   See Group Definition Format-Length:  A/N - 5
Effective Date:  1/1/1994 Revision Date:  January 1996
Deniable Data Element:  No

Definition:

The number which identifies the payer organization associated with this sequence for which the provider might expect some payment of the bill.

Codes and Values:

     1.   Payer         Type of Number
  Blue Cross Plan Number

  Commercial Insurers NAIC Number

  Medicaid State Agency Assigned number to be determined

  Medicare Blue Cross Number or Commercial Insurer NAIC Number depending on intermediary.

  CHAMPUS NAIC Number

     2.

  Must have been right justified and zero filled.
     3.   If this field was not applicable it must have contained zeros.

Edit Applications:
  1. If Source of Payment Code (Data Element 38) was Blue Cross ("G"), then Payer Identification was required and must have been valid in accordance with the Blue Cross and Blue Shield Plan Numbers in Appendix L.

  2. If Source of Payment Code (Data Element 38) was Insurance Company ("F"), then Payer Identification was required and must have been a valid numeric.