1. Provider, Begin and End Dates, Subscriber ID, Group Number, Last Name, First Name, and Date of Birth.
2. Provider, Begin and End Dates, Subscriber ID, Group Number, Last Name, and Date of Birth.
3. Provider, Begin and End Dates, Subscriber ID, Group Number, Last Name, and First Name.
4. Provider, Begin and End Dates, Social Security Number, Group Number, and Date of Birth.
Dates
Response Data
Benefits
The following information is based on a generic Health Benefit Plan Coverage - 30 inquiry.
- This payer has converted from Unknown; U network types to W for both in plan and out of plan networks (EB12=W). The 5010 implementation of this designation is a much better than the previous 4010 response.
- This payer has added the Family Unit number on more responses (REF01=49). Dependent data is being promoted and returned in the subscriber loop (2100C).
- This payer has added the service type for Durable Medical Equipment DM.
- This payer is no longer returning the service type for Chiropractic 33 and Durable Medical Equipment Rental 18.
- For some members, this payer is now returning a new active coverage for the generic Health Benefit Plan, with a plan description of RX. (EB*1**30**RX)