2010
Mar 
16

PRV segment explained

Filed under: Uncategorized — admin @ 11:53 pm  

The PRV segment in ANSI is used to identify the Taxonomy Code specialty of the Provider. You must send the PRV segment in each claim, either in the Billing Provider Loop which is 2000A or in the Rendering Provider Loop which is 2310B.

It is required to have the Taxonomy (PRV segment in the 2000A Billing Provider loop).
The only exception to this rule is if the Rendering and Billing are different
people. If they are different people you would then insert the PRV segment in the 2310B Rendering Provider loop.

If the 2310B Rendering Provider loop is not in the claim, then the PRV segment has to be used in the 2000A Billing Provider loop.

2000A Billing Provider Loop:
PRV*BI segment (“BI” represents BILLING)

2310B Rendering Provider Loop:
PRV*PE segment (“PE” represents PERFORMING)

It has come to the attention of Wave-EDI that an extremely small number of Insurance Companies are requiring that the PRV segment be sent in both the Billing and Rendering loops. This is against the ANSI 837p standard and we hope that this number does not increase.

Link for a list of Taxonomy Codes:
http://www.healthlink.com/tech_tip_taxonomy_code.asp