SBR Subscriber Information
SBR Subscriber Information
To record claim information specific to the primary insured and the insurance carrier for that insured
Position
Element
Name
Type
Requirement
Min
Max
Repeat
SBR-01
Payor Responsibility Sequence Number Code
Identifier (ID)
Mandatory
1
1
-
Code indentifying the insurance carrier's level of responsibility for a payment of a claim
SBR-02
Individual Relationship Code
Identifier (ID)
Optional
2
2
-
Code indicating the relationship between two individuals or entities.
SBR02 specifies the relationship to the person insured.
SBR-03
Reference Number
String (AN)
Optional
1
30
-
Reference number or identification number as defined for a particular Transaction Set, or as specified by the Reference Number Qualifier.
SBR03 is policy or group number.
SBR-04
Name
String (AN)
Optional
1
35
-
Free-form name.
SBR04 is plan name.
SBR-05
Insurance Type Code
Identifier (ID)
Optional
1
3
-
Code identifying the type of insurance policy within a specific insurance program
SBR-06
Coordination of Benefits Code
Identifier (ID)
Optional
1
1
-
Code identifying whether there is a coordination of benefits
SBR-07
Yes/No Condition or Response Code
Identifier (ID)
Optional
1
1
-
Code indicating a Yes or No condition or response.
SBR07 is destination payer code. A ``Y'' value indicates the payer is the destination payer. An ``N'' value indicates the payer is not the destination payer.
SBR-08
Employment Status Code
Identifier (ID)
Optional
2
2
-
Code showing the general employment status of an employee/claimant.
SBR-09
Claim Filing Indicator Code
Identifier (ID)
Optional
1
2
-
Code identifying the type of health insurance or program.