Showing posts with label 2100c. Show all posts
Showing posts with label 2100c. 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 | ~ |
DMG*D8*19571112
| 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
Questions or feedback are always welcome. You can email me at vbsenthilinnet@gmail.com.
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Labels:
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Thursday, January 26, 2017
271–5010 Health Care Eligibility Benefit Response – Loop 2100C Subscriber Name
271–5010 Health Care Eligibility Benefit Response – Loop 2100C Subscriber Name
Use this segment to identify an entity by name and/or identification number. Use this NM1 loop to identify the insured or subscriber
| Loop | Seg ID | Segment Name | Format | Length | Ref# | Req | Value |
| 2100C | NM1 | Subscriber Name | ID | 3 | R | NM1 | |
| Element Separator | AN | 1 | * | ||||
| NM101 | Entity Identifier Code | ID | 2/3 | 98 | R | IL | |
| Element Separator | AN | 1 | * | ||||
| NM102 | Entity Type qualifier | ID | 1/1 | 1065 | R | 1 | |
| Element Separator | AN | 1 | * | ||||
| NM103 | Name Last or Organization Name | AN | 1/60 | 1035 | R | Insured Person Last Name | |
| Element Separator | AN | 1 | * | ||||
| NM104 | Name First | AN | 1/35 | 1036 | S | Insured Person First Name | |
| Element Separator | AN | 1 | * | ||||
| NM105 | Name Middle | AN | 1/25 | 1037 | S | Insured Person Middle Name | |
| Element Separator | AN | 1 | * | ||||
| NM106 | Name Prefix | AN | 1/10 | 1038 | Not used | ||
| Element Separator | AN | 1 | * | ||||
| NM107 | Name Suffix | AN | 1/10 | 1039 | S | Insured Person Suffix | |
| Element Separator | AN | 1 | * | ||||
| NM108 | Identification code Qualifier | ID | 1/2 | 66 | R | MI | |
| Element Separator | AN | 1 | * | ||||
| NM109 | Identification code | AN | 2/80 | 67 | R | Insured Policy No | |
| Segment Terminator | ~ | ||||||
NM102 - Entity Type Qualifier
Code qualifying the type of entity
| Code | Definition |
| 1 | Person |
| 2 | Non-Person Entity |
NM1*IL*1*MULLIN*DANIEL****MI*XJBH12345678~
Segment Structure
SUBSCRIBER Additional identification
| Loop | Seg ID | Segment Name | Format | Length |