Segment: REF

Loop: 2310D   Segment: REF

Element: REF01 (Supervising Provider Secondary Identification Reference ID Qualifier)

When applicable and required, additional identifiers may be needed for a provider, when filing with a specific insurance.

If the Supervising Provider is an internal provider, edit the associated insurance company, and edit the internal provider underneath the insurance. Under the Rendering section, the additional identifiers will be indicated.

If the Supervising Provider is under Contacts, edit the Contact and find the Insurance Information at the bottom. To add specific secondary identifiers, add/edit the associated insurance company (listed on the claim), enter the appropriate codes for Location # (LU), Provider Commercial # (G2), UPIN (1G), or State License (OB).

Can hold up to 4 qualifiers.

Element: REF02 (Supervising Provider Secondary Identification Reference ID)

Inputs the ID numbers associated with any of the following indicated in the screens indicated in REF01:

  • Location # (LU)
  • Provider Commercial # (G2)
  • UPIN (1G)
  • State License (OB)