Showing posts with label care. Show all posts
Showing posts with label care. Show all posts

Tuesday, March 21, 2017

271–5010 Health Care Eligibility Benefit Response Subscriber Demographic Information and Subscriber Date –Loop 2100C

271–5010 Health Care Eligibility Benefit Response Subscriber Demographic Information and Subscriber Date –Loop 2100C


        

Subscriber Demographic Information.

Loop Seg ID Segment Name Format Length Ref# Req Value
2100C DMG Demographic Information ID 3 S DMG
Element Separator AN 1 *
DMG01 Date Time Period format Qualifier ID 2 1250 S D8 = Date format
Element Separator AN 1 *
DMG02 Date Time Period AN 8 1251 S <CCYYMMDD - Recipient Date of Birth>
Segment Terminator ~


Sample
DMG*D8*19571112

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Loop Seg ID Segment Name Format Length Ref# Req Value
2100C DTP Subscriber Date ID 3 R DTP
Element Separator AN 1 *
DTP01 Date Time Qualifier ID 2 374 R See values below
Element Separator AN 1 *
DTP02 Date Time Period Format Qualifier ID 2/3 1250 R D8 or RD8
Segment Terminator ~


DTP 01 – Date Time Qualifier
 
Code Definition
096 Discharge
102 Issue
152 Effective Date of Change
291 Plan
307 Eligibility
340 Consolidated Omnibus Budget Reconciliation Act (COBRA) Begin
341 Consolidated Omnibus Budget Reconciliation Act (COBRA) End
342 Premium Paid to Date Begin
343 Premium Paid to Date End
346 Plan Begin
347 Plan End
356 Eligibility Begin
357 Eligibility End
382 Enrolment
435 Admission
442 Date of Death
458 Certification
472 Service
539 Policy Effective
540 Policy Expiration
636 Date of Last Update
771 Status

DTP 02 – Date Time Period Qualifier

Code Definition
D8 Date Expressed in Format CCYYMMDD
RD8 Range of Dates Expressed in Format CCYYMMDD-CCYYMMDD


Sample

DTP*356*D8*20110101
DTP*346*D8*20140101
DTP*347*D8*20141231

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Questions or feedback are always welcome. You can email me at vbsenthilinnet@gmail.com. 


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Tuesday, March 14, 2017

271–5010 Health Care Eligibility Benefit Response Loop 2000A and 2100A Information Source Name

271–5010 Health Care Eligibility Benefit Response Loop 2000A and 2100A Information Source Name




        

Use the Information Source Level HL to identify the original entity who responded  i.e Insurance Company

Hierarchical ID Number
A unique number assigned by the sender to identify a particular data segment in a hierarchical structure.

HL01 shall contain a unique alphanumeric number for each occurrence  of the HL segment in the transaction set. For example, HL01 could be used to indicate the number of occurrences of the HL segment, in which case the value of HL01 would be “1" for the initial HL segment and would be incremented by one in each subsequent HL segment within the transaction. HL01 must begin with “1" and be incremented by one each time an HL is used in the transaction. Only numeric values are allowed in HL01.



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Loop Seg ID Segment Name Format Length Ref# Req Value
2000A HL Billing Hierarchical Level 2 R HL
Element Separator AN 1 *
HL01 Hierarchical ID Number AN 1/12 628 R 1
Element Separator AN 1 *
HL02 Hierarchical Parent ID Number 0 1/12 734 Not Used
Element Separator AN 1 *
HL03 Hierarchical Level Code ID 1/2 735 R 20  (Information Source)
Segment Terminator ~
HL04 Hierarchical Child Code ID 1/1 736 R 1
Segment End ~



 

Loop 2100A Information Source Name

Seg ID Segment Name Format Length Ref# Req Value
NM1 Information Source Name ID 3 R NM1
Element Separator AN 1 *
NM101 Entity Identifier Code ID 2/3 98 R See below for Set of values
Element Separator AN 1 *
NM102 Entity Type qualifier ID 1/1 1065 R 2 (See below for more Information)
Element Separator AN 1 *
NM103 Name Last or Organization Name AN 1/60 1035 R Insurance Name
Element Separator AN 1 *
NM104 Name First AN 1/35 1036 Not used
Element Separator AN 1 *
NM105 Name Middle AN 1/25 1037 Not Used
Element Separator AN 1 *
NM106 Name Prefix AN 1/10 1038 Not used
Element Separator AN 1 *
NM107 Name Suffix AN 1/10 1039 Not Used
Element Separator AN 1 *
NM108 Identification code Qualifier ID 1/2 66 R See be

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Monday, March 13, 2017

271–5010 Health Care Eligibility Benefit Response Loop 2000B And 2100B Information Receiver Name

271–5010 Health Care Eligibility Benefit Response Loop 2000B And 2100B Information Receiver Name


        

Use the Information Source Level HL to identify the original entity who received the response i.e Doctor Office

Hierarchical ID Number
A unique number assigned by the sender to identify a particular data segment in a hierarchical structure.

HL01 shall contain a unique alphanumeric number for each occurrence  of the HL segment in the transaction set. For example, HL01 could be used to indicate the number of occurrences of the HL segment, in which case the value of HL01 would be “1" for the initial HL segment and would be incremented by one in each subsequent HL segment within the transaction. HL01 must begin with “1" and be incremented by one each time an HL is used in the transaction. Only numeric values are allowed in HL01.


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Loop Seg ID Segment Name Format Length Ref# Req Value
2000A HL Billing Hierarchical Level 2 R HL
Element Separator AN 1 *
HL01 Hierarchical ID Number AN 1/12 628 R 1
Element Separator AN 1 *
HL02 Hierarchical Parent ID Number 0 1/12 734 Not Used
Element Separator AN 1 *
HL03 Hierarchical Level Code ID 1/2 735 R 21  (Information Receiver)
Segment Terminator ~
HL04 Hierarchical Child Code ID 1/1 736 R 1
Segment End ~


 

Loop 2100B Information Receiver Name

Seg ID Segment Name Format Length Ref# Req Value
NM1 Information Source Name ID 3 R NM1
Element Separator AN 1 *
NM101 Entity Identifier Code ID 2/3 98 R See below for Set of values
Element Separator AN 1 *
NM102 Entity Type qualifier ID 1/1 1065 R 2 (See below for more Information)
Element Separator AN 1 *
NM103 Name Last or Organization Name AN 1/60 1035 R Receiver Name
Element Separator AN 1 *
NM104 Name First AN 1/35 1036 Not used
Element Separator AN 1 *
NM105 Name Middle AN 1/25 1037 Not Used
Element Separator AN 1 *
NM106 Name Prefix AN 1/10 1038 Not used
Element Separator AN 1 *
NM107 Name Suffix AN 1/10 1039 Not Used
Element Separator AN 1 *
NM108 Identification code Qualifier ID 1/2 66 R See below for Set of values
Element Separator AN 1 Available link for download

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Thursday, February 23, 2017

271–5010 Health Care Eligibility Benefit Response – Loop 2000C Subscriber Level

271–5010 Health Care Eligibility Benefit Response – Loop 2000C Subscriber Level


 

        


Hierarchical ID Number
A unique number assigned by the sender to identify a particular data segment in a hierarchical structure.

HL01 shall contain a unique alphanumeric number for each occurrence  of the HL segment in the transaction set. For example, HL01 could be used to indicate the number of occurrences of the HL segment, in which case the value of HL01 would be “1" for the initial HL segment and would be incremented by one in each subsequent HL segment within the transaction. HL01 must begin with “1" and be incremented by one each time an HL is used in the transaction. Only numeric values are allowed in HL01.

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Loop Seg ID Segment Name Format Length Ref# Req Value
2000A HL Billing Hierarchical Level 2 R HL
Element Separator AN 1 *
HL01 Hierarchical ID Number AN 1/12 628 R 1
Element Separator AN 1 *
HL02 Hierarchical Parent ID Number 0 1/12 734 Not Used
Element Separator AN 1 *
HL03 Hierarchical Level Code ID 1/2 735 R 22  (Subscriber)
Segment Terminator ~
HL04 Hierarchical Child Code ID 1/1 736 R 1
Segment End ~

Sample :

HL*3*2*22*0


TRN Subscriber Trace Number
To uniquely identify a transaction to an application

Loop Seg ID Segment Name Format Length Ref# Req Value
2000C TRN Subscriber Trace Number ID 3 R TRN
Element Separator AN 1 *
TRN01 Trace Type Code ID 1 481 R See below for Set of values
Element Separator AN 1 *
TRN02 Reference Identification AN 1/50 127 R <Trace Number: Assigned by information receiver or information receiver’s clearing house>
Element Separator AN 1 *
TRN03 Originating Company Identifier AN 10 509 R <ID Number of the company that assigned the trace number>
    Element Separator         *
  TRN04 Reference Identification AN 1/50 127  

Trace Assigning Entity Additional Identifier. Required when it is necessary to further identify a specific component of
the company identified in the previous data element (TRN03). If not required by this implementation guide, do not send.

Segment Terminator ~
               


TRN01- Trace Type Code
Code Definition
1

(for Current Transaction Trace Numbers) – refers to trace or reference number assigned by the creator of the 271 transaction (the information source)

2

(for Referenced Transaction Trace Numbers) – refers to trace or reference numbers originally sent in the 270 transaction and returned in the 271


1. TRN02 provides unique identification for the transaction.
2. TRN03 identifies an organization.
3. TRN04 identifies a further subdivision within the organization.



Sample :

TRN*1*98175-012547*8877281234*RADIOLOGY~
TRN*1*109834652831*WXYZCLEARH*REALTIME~
TRN*2*090919391*3030240928



 

        
Questions or feedback are always welcome. You can email me at vbsenthilinnet@gmail.com.  

Available link for download

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