Roviyas

This loop is required only if current insurance sequence > 1. i.e. for secondary, tertiary, etc.

Say for example, if the current insurance is secondary, then we should run this loop for the primary insurance. If the current insurance is tertiary, then we should run this loop for the primary and then secondary insurance. And also so on. In general, take the sequence number of the current insurance, and run this loop for all the previous sequence insurance.

We need to repeat this loop for each line item in the claim.

When submitting coordination of benefits (COB) claims to Secondary Payer, the prior payer’s payment information must be included in the 837 claim file. There is important edit takes places in COB Claims at line item level for balancing the amounts.This edit is to verify that each charge line balances with the payment information at the line level. An example of line level balancing is below. The data in red provides an example of how the line level must balance.
 
Service Level (Loop 2400) line item charge amount Professional (SV102) or line item charge amount Institutional (SV203) = the sum of all other payer service line paid amounts (SVD02) at the service level (Loop 2430) + the sum of all the service line adjustments (CAS03) at the service level (Loop 2430)
 
Line level balancing:
SV1*HC:90834*137*UN*1***1:2:3
DTP*472*D8*20130513
SVD*99726*47.28*HC:90834**1
CAS*CO*45*77.86
CAS*PR*2*11.86
137 = 47.28 + 77.86 + 11.86

If there is balancing issue, then you will receive “Secondary Claim Information Missing or Invalid - Each line must balance; Line Charge Amount = Line Sum Of Adjustment Amounts + Line Payer Paid Amount”

2430 Line Adjudication Info - SVD Segment

2430 Line Adjustment CAS - Deductible

Loop	Seg ID	Segment Name	Format	Length	Ref#	Req	Value
2430	CAS	Line Adjustment	ID	3		S	CAS
		Element Separator	AN	1			*
	CAS01	Claim Adjustment Group Code	ID	1/2	1033	R	PR
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