Health America / Health Assurance (Commercial) - Quick Reference, What You Need to Know...
The official payer name is Coventry Health Care Health America/Health Assurance of Pennsylvania.
However, the old resource name of Health America/Health Assurance will remain in 5010, until which
time the 4010 version is retired. Once the 4010 version is retired, the payer name will be changed accordingly.

Search Options

• Previously this payer supported six search options. Now, this payer supports three search options as listed below.

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.

• For successful transaction processing, dependent data may be promoted to the subscriber loop.

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 returned.

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.”