1. Provider, Begin and End Dates, and Recipient ID.
2. Provider, Begin and End Dates, Social Security Number, and Date of Birth.
3. Provider, Begin and End Dates, Last Name, First Name, and Group Number.
Dates
Response Data
Benefits
The following information is based on a generic Health Benefit Plan Coverage - 30 inquiry.
- The list of coverage added now includes the following service types.
Medical Care 1
Chiropractic 33
Dental Care 35
Hospice 45
Hospital 47
Emergency Services 86
Pharmacy 88
Professional Physician Office Visit 98
Vision (Optometry) AL
Mental Health MH
Urgent Care UC
The only difference is that the 5010 response has a benefit description
qualifier (EB01=D) for Mental Health and Urgent Care coverage codes and
message text (MSG) indicating These are non covered service type codes.