ANSI 837 - Florida Blue - BCBSF

Florida Blue 837 P Companion Guide 2012Business Requirements for all Florida Blue and AvailityTrading Partners and ProvidersFailure to abide by these requirements will result in provider correctable errors and must becorrected and resubmitted.Req #Loop ID – Segment Description& Element NameTR3 DataElementTR3 Page(s)Plan RequirementB11000A - Submitter PrimaryIdentification NumberNM10975 Florida Blue requires the submission of the FloridaBlue assigned Sender Code in this data element.Identification CodeB21000A – Submitter EDI ContactInformationSubmitter Contact NamePER 0277 Required when the contact name is different thanthe name contained in the Submitter Namesegment of this loop and it is the first iteration ofthe Submitter EDI Contact Information Segment.B31000B – Receiver NameLast Name or Organization NameNM10380 BCBSFFlorida Blue requires submission of above value inthis field.B41000B – Receiver NameReceiver Primary IdentificationNumberNM10980 592015694Florida Blue requires submission of above value inthis fieldB52000B – Subscriber HierarchicalLevelClaim Filing Indicator CodeSBR09 118 BLFlorida Blue requires submission of the above valuein this field.B6 2000A-Billing Provider Taxonomy PRV03 83 Taxonomy codes are required by Florida Blueunder specific circumstances. Taxonomy is one ofseveral data elements used by Florida Blue to helpdetermine the appropriate provider record forprocessing. In cases where the NPI is shared bymultiple provider entities, specialties or locations,the taxonomy becomes a critical data element.Taxonomy codes can be located at www.nucc.org.141 Availity, LLC Is a multi-payer joint venture company. For more information or to register, visit Availity’s website atwww.availity.com.900-3398-1112005010X222A1Florida Blue December 2012For example. ABC hospital, Urgent Care, Lab andPhysician PA group all share the same NPI. In this