Exception Options for the 4010 and 5010 Formats

Option	Setting
File Options
Force Rendering information	Forces the creation of the rendering provider segments on non-billing group claims.
Force Subscriber information	Populates the subscriber demographics segments when the patient is not the insured. This option populates the DMG and address segments in the subscriber loop of the 837 file for both 837I and 837P.
Globally enable National Provider Identifier (NPI)	Enables sending NPIs. This submitter profile option applies to any fields (provider, group, or location) that have a saved NPI number in the master file. If an NPI is not in the master files, then the Tax ID becomes the default used for the rendering and group. The field for Tax ID does not populate for locations.
Create Transaction Set(s) (ST/SE) per Payer Alias instead of Payer	Groups the claims by payer alias. When this option is activated and the eTrans ID changes but not the payer Alias, a break in the claim is created. When this option is not activated, claims are grouped by Payer ID.
Create QSI Dental special format (ADA Claims)	Sends this segment whenever the tooth, surface, or quadrant populate for a claim line item.
Create Transaction Set(s) (ST/SE) per Billing Provider	Creates a new ST-SE loop when you are breaking the claim by billing provider.
Break 2000A loop on Billing information only (not Rendering) OR (below)	Breaks the 2000A loop by billing provider only.
Break 2000A loop on FL51 change (UB92 Claims) (if above unchecked)	Breaks the UB92 claims on: FL51 number change Location
Break 2000B loop on every claim	Forces a billing provider (2000B) break for every claim. When selected, this option generates a separate 2000B loop for every 837 electronic claim; if not, one 2000B generates for the same subscriber.
Begin Hierarchical Transaction [Header Loop BHT Segments]
Increment reference ID counter (BHT03)*	Increments the reference ID counter (BHT03) by one, each time an ST or SE segment is included in the 837 file.
Reference ID (BHT03) counter value*	Enter a value that the reference counter ID starts from. For example, if you enter the value 10 in the Setting column, then the first reference ID for the first ST or SE segment in the 837 file is 10. The second ST or SE segment reference ID, which is incremented by one, has a reference ID of 11.
Reference ID (BHT03) counter max*	Enter a maximum value that the reference ID counter can increment to before resetting. For example, if the reference counter is supposed to reset after the twentieth ST or SE segment in the 837 file, then enter 20 in the Setting column to the right of this option. When the reference ID counter reaches 20, it resets to the value that is set up in the reference ID counter value field.
Provider Specialty [PRV Segments]
Populate Provider Specialty Information (PRV05)	Populates the PRV05 element position in the 837 file with the provider specialty. This option should only be activated when you are setting up a submitter profile for a clearinghouse that translates the 837 file back to the NSF format.
Contact Information [1000A Loop PER Segments]
Contact EDI number [PER04/06/08]	Enter the contact EDI number in the Setting column.
Subscriber Information [2000B Loop SBR Segments]
Override Insurance Type Code on Medicare Secondary/Tertiary Claims	Overrides the Insurance Type Code on the secondary or tertiary Medicare claims. You can select from the list: none 12-Medicare Secondary w/Employer Group Health Plan 13-Medicare Secondary End-Stage Renal Disease Beneficiary 14-Medicare Secondary, No-fault Insurance including Auto is Primary 15-Medicare Secondary, Worker's Compensation 16-Medicare Secondary Public Health Service (PHS) or Other Federal Agency 41-Medicare Secondary Black Lung 42-Medicare Secondary Veteran's Administration 43-Medicare Secondary Disabled <65 with Large Group Health Plan (LGHP) 47-Medicare Secondary, Other Liability Insurance is Primary The default value is 12. If an MSP Reason is set on the Detail 2 tab of the Insurance Maintenance window, it overrides the submitter profile setting.
NM1 Billing/Rendering Provider Name [2010AA/2310B Loops]
Populate NM103 with the Provider/Payer Name/Organization (NM103)	Places the provider name, payer name, or the name of the organization in the NM103 segment.
Populate NM109 with the Phys Billing Id [NM109]	Places the group ID or individual ID in the NM109 segment instead of the tax ID. This option is only used for professional claims.
Populate NM107 with the specified provider credentials (comma-separated)	Places the specified provider credential in the NM107 segment.
Billing/Pay-To Provider [2010AA/2010AB Loops]
Populate Billing address with Service Location and Pay-To with Billing Information	Populates the Pay-To Provider loop with billing information and to populate the billing address with the service location address.
Populate Pay-To Provider with Group and Billing Provider with Rendering	Populates the Pay-To Provider loop with the group information and to populate the billing provider with the rendering information.
Subscriber Information [2010BA Loop Segments]
Patient/Subscriber Override Policy Number [NM109]	Patient's Number in 2010BA only: Override patient policy numbers print in the subscriber loop (2010BA, NM109), and the patient loop will not contain a policy number Subscriber # in 2010BA/Patient's # in 2010CA: Override policy numbers print in the patient loop (2010CA, NM109) and the insured's policy number prints in the subscriber loop (2010BA, NM109)
Append plan code to the end of policy number	Appends the plan code to the end of the policy number.
Populate Secondary Identification with Subscriber SSN Number (REF)	You can override this setting with the payer option Payers master file > System tab > Electronic Claims subtab> Populate subscriber secondary ID with SSN check box.
Primary Payer [2010BB Loop Segments]
Location(s) using Payer Alias [NM103]	Select one of the following payer alias options for the electronic claim file: <none> 1000B, NM103, and 2010BB NM103: Uses the payer alias from the Payer master for both the 1000B, NM103, and 2010BB, NM103) 1000B, NM103 only: Uses the payer alias from the payer master for the 1000B, NM103, and uses the payer name for 2010BB, NM103 2010BB, NM103 only: Uses the payer name from the payer master for the 1000B, NM103, and uses the payer alias for 2010BB, NM103
Populate Plan Code as REF02 (FY Qualifier)	Sends a REF segment in the 2010BB loop. The plan code (payer secondary qualifier) displays in the 2010BB - REF segment when this option is activated.
Claim Information [2300 Loop CLM Segments]
Populate Patient Ctrl Number with Unique Claim ID Number (CLM01)	Sends the unique system-assigned claim ID number instead of the patient control (Encounter) number in the 2300 CLM01 segment.
Suppress CLM16 Value [CLM16]	Suppresses the default value of P for CLM16 for professional claims.
Claim Date Information [2300 Loop DTP Segments]
Force Similar Illness/Symptom Onset Date (DTP 438)	Includes the onset date (DTP 438 segment), if it is available. This option populates Box 15 on the HCFA paper claim form.
Populate Discharge Hour for Institutional claims (DTP 096)	Populates the discharge hour for institutional claims. The default is 0800.
Claim Amounts Due [2300 Loop AMT Segments]
Report Payer Estimated Amount Due (Institutional AMT02)	Populates the 2300 level AMTC5 segment for institutional (UB) claims attached to the submitter. The AMTC5 segment indicates the estimated amount due by the payer. Note: This option is only available for the 4010 format.
Claim Prior Authorization or Referral Number [2300 REF Segment]
Use Referral Number '9F' qualifier	Uses the 9F qualifier instead of the G1 qualifier for 2300 REF segment for authorizations.
Claim Note [2300 Loop NTE Segment]
Report Claim Note (2300 NTE) instead of Line Item Note (2400 NTE)	Enables the narrative to be put in the 2300 claim-level NTE segment instead of the 2400 detail-level NTE segment. If there are multiple narratives, the system concatenates them in order.
Principal Procedure Information [2300 Loop H1 Segment]
Report first non clinic rate line item as the Principal Procedure	Reports the first non-clinic rate line item as the principle procedure code with a qualifier of BP.
Populate date in 2300 Principal Procedural Info (HI01-4) for ICD Diagnoses	Generates the file with the date even if the qualifier is a BP for ICD coding.
Populate date in 2300 Principal Procedural Info (HI01-4) for CPT4 Diagnoses	Causes the file to be generated with the date even if the qualifier is a BP for CPT4 coding.
Principal Diagnosis Information [2300 Loop HI Segment]
Populate admitting diagnosis code	Populates the 2300 CLM HI segment with the PR qualifier and the first diagnosis on the charge for institutional claim.
Do not include 2300 loop, HI segment if there is not a diagnosis on the claim	NextGen In-line Edits hides the HI segment when the diagnosis code is not present. If the option is disabled and the diagnosis code is not present, an HI segment displays without the diagnosis code.
Referring Provider [2310A Loop Segments]
Populate Referring Tax ID with Provider Default Tax ID (NM109)	Populates the default provider tax ID as the referring NM109.
Attending Physician [2310A Loop Segments]
Use default ID for Attending Physician ID (NM109)	Enter a default ID number. If that field in the electronic submission file is blank, it now populates with the ID entered here.
Operating Physician [2310B Loop Segments]
Populate Operating Physician Information if applicable	Populates the operating physician loop (2310B) with physician information, if applicable.
Other Provider Information [institutional 2310C Loop Segments]
Populate Other Provider with Referring Provider information	Populates the other provider loop (2310c) with referring provider information that is attached to the encounter. To populate the loop correctly, the provider must have a UPIN and Default Tax ID number entered on the System tab of the Provider master file.
Purchased Service Provider Name [2310C Loop NM1 Segment]
Populate Purchased Service Provider Name (NM103 & NM104)	Populates Purchased Service 2310C, NM103 and NM104 on the electronic HCFA 1500 claim.
Service Facility Information [Institutional 2310E Loop NM1 Segment]
Populate Location Tax ID (NM108 and NM109)	Populates the Location Tax ID in the 2310E NM1 segment if the NPI is inactive or blank. The location tax ID must be set in the Location master file.
Supervising Provider Information [2310E Loop NM1 Segment]
Populate Supervisor Information if applicable	Prints supervising provider information on the claim. The supervising information populates the 837 electronic file only if the rendering is a PA (or a specialty that has enable supervising billing flagged) and is credentialed. If multiple secondary reference qualifiers are set up at the practice level, the supervisor also needs to be set up. If secondary reference qualifiers are set up, the REF segment displays the appropriate qualifier and data value. Otherwise, only the NM1 segment will display.
Populate Supervising Provider when same as Rendering	Prints supervising provider information on the claim when the supervising physician is also the rendering physician. The information appears in the NM1 segment of the 2310 loop.
Populate Billing Prov with Supervising Prov if Enabled	Populates the Billing Provider loop (2000A) with the information from the Supervising Provider loop (2310E) if the rendering physician is not fully qualified, for example, if the rendering physician is a physician assistant.
Other Subscriber Information [2320 Loop SBR Segments]
Use HIPAA Relationship Code Values (SBR02)	Updates the relationship codes for Other Subscriber (SBR02) for both Professional and Institutional claims.
No Insurance Type Code for Other Subscribers [SBR05] on Institutional Claims	Prevents the display of the insurance type in the 837 electronic file in the Insurance Type Code field in the 2320 SBR segment.
Other Subscriber Information [2320 Loop NM1 Segments]
Use Override Policy Number (NM109)	Populates the NM109 for the other subscriber with the override policy number. The plan number of the secondary insurance appears in the 2330A loop.
Other Subscriber Information [2320 Loop AMT Segments]
Suppress AMT segments	Excludes the AMT segment in the 2320 loop when submitting primary claims. This option is used when the secondary payment has been posted and the claim is being resubmitted to the primary. Note: This option is only available for the 4010 format.
Populate claim-level approved amount AMT segment in the 2320 Loop	Populates the claim-level approved amount AMT segment in the 2320 loop of the claim. Note: This option is only available for the 4010 format.
Other Payer Claim Adjustments [2320 Loop CAS Segments]
Populate claim-level CAS segments in the 2320 Loop	Displays adjustment information at both the claim and detail levels.
Other Payer [2330B Loop Segments]
Report Medigap/COBA ID if available [NM109]	Populates the NM109 segment in the 2330B loop with the Medigap/COBA ID instead of the NEIC/e Trans ID when the other payer is Medigap.
Professional Service Item [2400 Loop SV1 Segments]
Populate Service Type Codes (SV106)*	Sets up a submitter profile for a clearinghouse that translates the 837 file back to NSF format.
Report minutes instead of units on Anesthesia claims (SV104)	Changes the reporting of anesthesia-type service items from anesthesia units to minutes. It changes UN in SV103 to MJ. It also changes the calculation of units for anesthesia claims (base units + (# of minutes/15)) to the total number of minutes in SV104.
Institutional Service Item [2400 Loop SV2 Segments]
Do not report the Clinic Rate SIM	Prevents reporting of the encounter rate SIM and exclude the encounter rate charge amount from the total claim amount in the CLM segment.
Suppress HCPCS Qualifier (SV202-1) if HCPCS Code (SV202-2) is blank	Prevents a value being placed in the 2400, SV202-1 when no value populates the SV202-2 field.
Service Item [2400 Loop SV1/SV2 Segments]
Enable procedure codes up to nine characters long	Allows 9-digit procedure codes in the 837 electronic file.
Service Date [2400 Loop DTP Segments]
Always send date range in DTP segment	Prints the date of service as the beginning and ending dates in the 2400 loop when no date range is specified.
DMERC CRC [2400 Loop CRC Segments]
Do not populate DMERC CRC segment	Populates the ordering provider information with the referring provider information on claims that are DME.
Anesthesia NTE [Professional 2400 Loop NTE Segment]
Populate with start and stop times if narrative is blank	Populates the NTE segment with START [start time] and STOP [stop time] when the narrative in charge entry is blank for an anesthesia SIM.
Ordering Provider [2420E Loop Segments]
Populate Ordering Prov. with Referring Prov. on Professional DME Claims	Activate this option only for DME claims. This creates the Ordering Phys loop only for SIMs that are marked as DME.

Option	Setting
File Options
Force Rendering information	Forces the creation of the rendering provider segments on non-billing group claims.
Force Subscriber information	Populates the subscriber demographics segments when the patient is not the insured. This option populates the DMG and address segments in the subscriber loop of the 837 file for both 837I and 837P.
Globally enable National Provider Identifier (NPI)	Enables sending NPIs. This submitter profile option applies to any fields (provider, group, or location) that have a saved NPI number in the master file. If an NPI is not in the master files, then the Tax ID becomes the default used for the rendering and group. The field for Tax ID does not populate for locations.
Create Transaction Set(s) (ST/SE) per Payer Alias instead of Payer	Groups the claims by payer alias. When this option is activated and the eTrans ID changes but not the payer Alias, a break in the claim is created. When this option is not activated, claims are grouped by Payer ID.
Create QSI Dental special format (ADA Claims)	Sends this segment whenever the tooth, surface, or quadrant populate for a claim line item.
Create Transaction Set(s) (ST/SE) per Billing Provider	Creates a new ST-SE loop when you are breaking the claim by billing provider.
Break 2000A loop on Billing information only (not Rendering) OR (below)	Breaks the 2000A loop by billing provider only.
Break 2000A loop on FL51 change (UB92 Claims) (if above unchecked)	Breaks the UB92 claims on: FL51 number change Location
Break 2000B loop on every claim	Forces a billing provider (2000B) break for every claim. When selected, this option generates a separate 2000B loop for every 837 electronic claim; if not, one 2000B generates for the same subscriber.
Begin Hierarchical Transaction [Header Loop BHT Segments]
Increment reference ID counter (BHT03)*	Increments the reference ID counter (BHT03) by one, each time an ST or SE segment is included in the 837 file.
Reference ID (BHT03) counter value*	Enter a value that the reference counter ID starts from. For example, if you enter the value 10 in the Setting column, then the first reference ID for the first ST or SE segment in the 837 file is 10. The second ST or SE segment reference ID, which is incremented by one, has a reference ID of 11.
Reference ID (BHT03) counter max*	Enter a maximum value that the reference ID counter can increment to before resetting. For example, if the reference counter is supposed to reset after the twentieth ST or SE segment in the 837 file, then enter 20 in the Setting column to the right of this option. When the reference ID counter reaches 20, it resets to the value that is set up in the reference ID counter value field.
Provider Specialty [PRV Segments]
Populate Provider Specialty Information (PRV05)	Populates the PRV05 element position in the 837 file with the provider specialty. This option should only be activated when you are setting up a submitter profile for a clearinghouse that translates the 837 file back to the NSF format.
Contact Information [1000A Loop PER Segments]
Contact EDI number [PER04/06/08]	Enter the contact EDI number in the Setting column.
Subscriber Information [2000B Loop SBR Segments]
Override Insurance Type Code on Medicare Secondary/Tertiary Claims	Overrides the Insurance Type Code on the secondary or tertiary Medicare claims. You can select from the list: none 12-Medicare Secondary w/Employer Group Health Plan 13-Medicare Secondary End-Stage Renal Disease Beneficiary 14-Medicare Secondary, No-fault Insurance including Auto is Primary 15-Medicare Secondary, Worker's Compensation 16-Medicare Secondary Public Health Service (PHS) or Other Federal Agency 41-Medicare Secondary Black Lung 42-Medicare Secondary Veteran's Administration 43-Medicare Secondary Disabled <65 with Large Group Health Plan (LGHP) 47-Medicare Secondary, Other Liability Insurance is Primary The default value is 12. If an MSP Reason is set on the Detail 2 tab of the Insurance Maintenance window, it overrides the submitter profile setting.
NM1 Billing/Rendering Provider Name [2010AA/2310B Loops]
Populate NM103 with the Provider/Payer Name/Organization (NM103)	Places the provider name, payer name, or the name of the organization in the NM103 segment.
Populate NM109 with the Phys Billing Id [NM109]	Places the group ID or individual ID in the NM109 segment instead of the tax ID. This option is only used for professional claims.
Populate NM107 with the specified provider credentials (comma-separated)	Places the specified provider credential in the NM107 segment.
Billing/Pay-To Provider [2010AA/2010AB Loops]
Populate Billing address with Service Location and Pay-To with Billing Information	Populates the Pay-To Provider loop with billing information and to populate the billing address with the service location address.
Populate Pay-To Provider with Group and Billing Provider with Rendering	Populates the Pay-To Provider loop with the group information and to populate the billing provider with the rendering information.
Subscriber Information [2010BA Loop Segments]
Patient/Subscriber Override Policy Number [NM109]	Patient's Number in 2010BA only: Override patient policy numbers print in the subscriber loop (2010BA, NM109), and the patient loop will not contain a policy number Subscriber # in 2010BA/Patient's # in 2010CA: Override policy numbers print in the patient loop (2010CA, NM109) and the insured's policy number prints in the subscriber loop (2010BA, NM109)
Append plan code to the end of policy number	Appends the plan code to the end of the policy number.
Populate Secondary Identification with Subscriber SSN Number (REF)	You can override this setting with the payer option Payers master file > System tab > Electronic Claims subtab> Populate subscriber secondary ID with SSN check box.
Primary Payer [2010BB Loop Segments]
Location(s) using Payer Alias [NM103]	Select one of the following payer alias options for the electronic claim file: <none> 1000B, NM103, and 2010BB NM103: Uses the payer alias from the Payer master for both the 1000B, NM103, and 2010BB, NM103) 1000B, NM103 only: Uses the payer alias from the payer master for the 1000B, NM103, and uses the payer name for 2010BB, NM103 2010BB, NM103 only: Uses the payer name from the payer master for the 1000B, NM103, and uses the payer alias for 2010BB, NM103
Populate Plan Code as REF02 (FY Qualifier)	Sends a REF segment in the 2010BB loop. The plan code (payer secondary qualifier) displays in the 2010BB - REF segment when this option is activated.
Claim Information [2300 Loop CLM Segments]
Populate Patient Ctrl Number with Unique Claim ID Number (CLM01)	Sends the unique system-assigned claim ID number instead of the patient control (Encounter) number in the 2300 CLM01 segment.
Suppress CLM16 Value [CLM16]	Suppresses the default value of P for CLM16 for professional claims.
Claim Date Information [2300 Loop DTP Segments]
Force Similar Illness/Symptom Onset Date (DTP 438)	Includes the onset date (DTP 438 segment), if it is available. This option populates Box 15 on the HCFA paper claim form.
Populate Discharge Hour for Institutional claims (DTP 096)	Populates the discharge hour for institutional claims. The default is 0800.
Claim Amounts Due [2300 Loop AMT Segments]
Report Payer Estimated Amount Due (Institutional AMT02)	Populates the 2300 level AMTC5 segment for institutional (UB) claims attached to the submitter. The AMTC5 segment indicates the estimated amount due by the payer. Note: This option is only available for the 4010 format.
Claim Prior Authorization or Referral Number [2300 REF Segment]
Use Referral Number '9F' qualifier	Uses the 9F qualifier instead of the G1 qualifier for 2300 REF segment for authorizations.
Claim Note [2300 Loop NTE Segment]
Report Claim Note (2300 NTE) instead of Line Item Note (2400 NTE)	Enables the narrative to be put in the 2300 claim-level NTE segment instead of the 2400 detail-level NTE segment. If there are multiple narratives, the system concatenates them in order.
Principal Procedure Information [2300 Loop H1 Segment]
Report first non clinic rate line item as the Principal Procedure	Reports the first non-clinic rate line item as the principle procedure code with a qualifier of BP.
Populate date in 2300 Principal Procedural Info (HI01-4) for ICD Diagnoses	Generates the file with the date even if the qualifier is a BP for ICD coding.
Populate date in 2300 Principal Procedural Info (HI01-4) for CPT4 Diagnoses	Causes the file to be generated with the date even if the qualifier is a BP for CPT4 coding.
Principal Diagnosis Information [2300 Loop HI Segment]
Populate admitting diagnosis code	Populates the 2300 CLM HI segment with the PR qualifier and the first diagnosis on the charge for institutional claim.
Do not include 2300 loop, HI segment if there is not a diagnosis on the claim	NextGen In-line Edits hides the HI segment when the diagnosis code is not present. If the option is disabled and the diagnosis code is not present, an HI segment displays without the diagnosis code.
Referring Provider [2310A Loop Segments]
Populate Referring Tax ID with Provider Default Tax ID (NM109)	Populates the default provider tax ID as the referring NM109.
Attending Physician [2310A Loop Segments]
Use default ID for Attending Physician ID (NM109)	Enter a default ID number. If that field in the electronic submission file is blank, it now populates with the ID entered here.
Operating Physician [2310B Loop Segments]
Populate Operating Physician Information if applicable	Populates the operating physician loop (2310B) with physician information, if applicable.
Other Provider Information [institutional 2310C Loop Segments]
Populate Other Provider with Referring Provider information	Populates the other provider loop (2310c) with referring provider information that is attached to the encounter. To populate the loop correctly, the provider must have a UPIN and Default Tax ID number entered on the System tab of the Provider master file.
Purchased Service Provider Name [2310C Loop NM1 Segment]
Populate Purchased Service Provider Name (NM103 & NM104)	Populates Purchased Service 2310C, NM103 and NM104 on the electronic HCFA 1500 claim.
Service Facility Information [Institutional 2310E Loop NM1 Segment]
Populate Location Tax ID (NM108 and NM109)	Populates the Location Tax ID in the 2310E NM1 segment if the NPI is inactive or blank. The location tax ID must be set in the Location master file.
Supervising Provider Information [2310E Loop NM1 Segment]
Populate Supervisor Information if applicable	Prints supervising provider information on the claim. The supervising information populates the 837 electronic file only if the rendering is a PA (or a specialty that has enable supervising billing flagged) and is credentialed. If multiple secondary reference qualifiers are set up at the practice level, the supervisor also needs to be set up. If secondary reference qualifiers are set up, the REF segment displays the appropriate qualifier and data value. Otherwise, only the NM1 segment will display.
Populate Supervising Provider when same as Rendering	Prints supervising provider information on the claim when the supervising physician is also the rendering physician. The information appears in the NM1 segment of the 2310 loop.
Populate Billing Prov with Supervising Prov if Enabled	Populates the Billing Provider loop (2000A) with the information from the Supervising Provider loop (2310E) if the rendering physician is not fully qualified, for example, if the rendering physician is a physician assistant.
Other Subscriber Information [2320 Loop SBR Segments]
Use HIPAA Relationship Code Values (SBR02)	Updates the relationship codes for Other Subscriber (SBR02) for both Professional and Institutional claims.
No Insurance Type Code for Other Subscribers [SBR05] on Institutional Claims	Prevents the display of the insurance type in the 837 electronic file in the Insurance Type Code field in the 2320 SBR segment.
Other Subscriber Information [2320 Loop NM1 Segments]
Use Override Policy Number (NM109)	Populates the NM109 for the other subscriber with the override policy number. The plan number of the secondary insurance appears in the 2330A loop.
Other Subscriber Information [2320 Loop AMT Segments]
Suppress AMT segments	Excludes the AMT segment in the 2320 loop when submitting primary claims. This option is used when the secondary payment has been posted and the claim is being resubmitted to the primary. Note: This option is only available for the 4010 format.
Populate claim-level approved amount AMT segment in the 2320 Loop	Populates the claim-level approved amount AMT segment in the 2320 loop of the claim. Note: This option is only available for the 4010 format.
Other Payer Claim Adjustments [2320 Loop CAS Segments]
Populate claim-level CAS segments in the 2320 Loop	Displays adjustment information at both the claim and detail levels.
Other Payer [2330B Loop Segments]
Report Medigap/COBA ID if available [NM109]	Populates the NM109 segment in the 2330B loop with the Medigap/COBA ID instead of the NEIC/e Trans ID when the other payer is Medigap.
Professional Service Item [2400 Loop SV1 Segments]
Populate Service Type Codes (SV106)*	Sets up a submitter profile for a clearinghouse that translates the 837 file back to NSF format.
Report minutes instead of units on Anesthesia claims (SV104)	Changes the reporting of anesthesia-type service items from anesthesia units to minutes. It changes UN in SV103 to MJ. It also changes the calculation of units for anesthesia claims (base units + (# of minutes/15)) to the total number of minutes in SV104.
Institutional Service Item [2400 Loop SV2 Segments]
Do not report the Clinic Rate SIM	Prevents reporting of the encounter rate SIM and exclude the encounter rate charge amount from the total claim amount in the CLM segment.
Suppress HCPCS Qualifier (SV202-1) if HCPCS Code (SV202-2) is blank	Prevents a value being placed in the 2400, SV202-1 when no value populates the SV202-2 field.
Service Item [2400 Loop SV1/SV2 Segments]
Enable procedure codes up to nine characters long	Allows 9-digit procedure codes in the 837 electronic file.
Service Date [2400 Loop DTP Segments]
Always send date range in DTP segment	Prints the date of service as the beginning and ending dates in the 2400 loop when no date range is specified.
DMERC CRC [2400 Loop CRC Segments]
Do not populate DMERC CRC segment	Populates the ordering provider information with the referring provider information on claims that are DME.
Anesthesia NTE [Professional 2400 Loop NTE Segment]
Populate with start and stop times if narrative is blank	Populates the NTE segment with START [start time] and STOP [stop time] when the narrative in charge entry is blank for an anesthesia SIM.
Ordering Provider [2420E Loop Segments]
Populate Ordering Prov. with Referring Prov. on Professional DME Claims	Activate this option only for DME claims. This creates the Ordering Phys loop only for SIMs that are marked as DME.

Exception Options for the 4010 and 5010 Formats

Recommendations

Exception Options for the 5010 Format

Exception Options for the 4010 and 5010 Formats

Exception Options for the 4010 Format

Exception Options for the 4010 Format

Exception Options for the 5010 Format

Exception Options for the 5010 Format

Exception Options for the 4010 and 5010 Formats

Exception Options for the 5010 Format

Exception Options for the 4010 and 5010 Formats

Exception Options for the 4010 Format

Exception Options for the 4010 Format

Exception Options for the 5010 Format

Exception Options for the 5010 Format