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How Do I Correct Segment SBR09 On My Eclaims?

When Payer or Office Ally indicates that segment SBR09 is incorrect on your eclaims.

Every Payer has a different requirement for what they would like to appear on the HCFA claims form under the section of 'Insurance Type'. When transmitted eclaims, this is sent in a segment titled 'SBR09'. Outlined below is information on where this is located in the system in the event you need to change/update this info.

When setting up an insurance company the 'Insurance Type' is where the SBR09 information is pulled from and the coding that will appear in this segment for eclaims. 

SBR

Below is a full list of all the coding options for Segment SBR09:

  • 11 - Other Non-Federal Programs

  • 12 - Preferred Provider Organization (PPO)

  • 13 - Point of Service (POS)

  • 14 - Exclusive Provider Organization (EPO)

  • 15 - Indemnity Insurance

  • 16 - Health Maintenance Organization (HMO) Medicare Risk

  • 17 - Dental Maintenance Organization

  • AM - Automobile Medical

  • BL - Blue Cross/Blue Shield

  • CH - Champus

  • CI - Commercial Insurance Co.

  • DS - Disability

  • FI - Federal Employees Program

  • HM - Health Maintenance Organization

  • LM - Liability Medical

  • MA - Medicare Part A

  • MB - Medicare Part B

  • MC - Medicaid

  • OF - Other Federal Program

  • TV - Title V

  • VA - Veterans Affairs Plan

  • WC - Workers’ Compensation Health Claim

  • ZZ - Mutually Defined (This is generic default setting)

Note: The following handful of insurance types are also marked as Mutually Defined and will appear as default ZZ:

  • 09 - Self Pay

  • 10 - Central Certification

  • LI - Liability

  • FC - Feca