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 ~


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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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


 
        

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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
 
Sample
NM1*IL*1*MULLIN*DANIEL****MI*XJBH12345678~

Segment Structure
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SUBSCRIBER Additional identification

Loop Seg ID Segment Name Format Length

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