Mutual of Omaha (Commercial) - Quick Reference, What You Need to Know...
Search Options
-
Previously, this payer supported two search options.
Now, this payer only supports one search option as listed below.
1. Provider ID, Begin Date,
Subscriber ID, Patient Last Name, Patient First Name, Patient Date of
Birth,
and Relationship to Subscriber.
- The
optional group number is ignored and not used in the inquiry.
- This
payer does not promote dependent data. For this reason, it is necessary
for a transaction
to use either a subscriber or dependent loop, depending on the specified
value of the relationship code.
Dates
-
Dates now reference a Plan Date – 291
(DTP01) in a range format. The End Date is optional on the inquiry.
-
Date references for Eligibility – 307 are
not used.
Response Data
Benefits
The following information is based on a
generic “Health Benefit Plan Coverage - 30” inquiry.
-
Basically, Mutual of Omaha did not change anything in their 5010
implementation.
Since most of the information is all Medicare Supplement, the amount
of demographic
data is consistent with the previous response.
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.