1. Provider, Date, Subscriber ID, Patient Last Name, Patient First Name, Patient Date of Birth, and Relationship to Subscriber.
2. Provider, Date, Subscriber ID, Patient Last Name, Patient First Name, and Relationship to Subscriber.
3. Provider, Date, Subscriber ID, Patient Date of Birth, and Relationship to Subscriber.
4. Provider, Date, Patient Last Name, Patient First Name, Patient Date of Birth, and Relationship to Subscriber.
Response Data
Benefits
The following information is based on a generic “Health Benefit Plan Coverage - 30” inquiry.
This payer now returns an additional subscriber reference for a plan number.
Basically, this is supplied in a REF segment that specifies the plan number.
However, the supplemental identifier and description for a plan, group, or plan network name may need to be decoded.Response detail for Emergency Services – 86 are not returned.
Message segments have been removed for Medicare Supplemental Policy.
There is no indication if this payer accepts the repetition separated values for service type codes (EQ01).
In other words, it is not known if multiple service types are acceptable for single inquiries.