Kansas
(Medicaid) - Quick Reference, What You Need to Know...
Search Options
- No
changes in search options or search criteria.
- For
successful transaction processing, dependent data may be promoted to the
subscriber loop.
Dates
-
Previously, date spans were only allowed
within the current month. Now, up to a 90-day date range is allowable.
-
No future dates or dates before 1950 are
allowable.
Response Data
Benefits
The following information is based on a
generic “Health Benefit Plan Coverage - 30” inquiry.
-
Managed Care Organization (MCOs) data is provided in a better
format.
The response still provides Medical, Mental Health, and transaction
MCO names.
-
This payer now associates each MCO and Managed Care Plans with the
proper Service Type Code.
Previously, a generic service type of Health Benefit Plan Coverage
was used for all MCO data.
Now, MCO and Managed Care Plans may specify Medical Care or Mental
Health.
-
Primary Care Providers (PCPs) are also returned with specific
service types.
-
The Service Type associated with various Plan Code Descriptions has
also changed in the response.
-
Latest Visit or Consultation dates may not be returned for routine
visits.
Demographics
- The
names may be returned in all capital characters. Previously, this
information was returned using initial capitalization.
Disclaimer
This document is not intended to identify every scenario that may be
presented in the payer response.
It should
also be noted, that the payer response may vary depending on the search
criteria used in the initial inquiry.
Some content
is no longer returned in the X12 5010 271 response. In a similar fashion,
some content has been
modified and
new response information may be returned. Information that appeared
consistent between the
4010 and 5010
responses was not presented in this document.