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Back  RFI # 1149: EB01=D usage in 271 response

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Submitter

Ajay Balu

Description

Hi,
on the 271 eligiblity response, EB01 value can "D" ( Benefit Description). could you please let me know in which health care scenario this benefit description field can be used?

for Example : if EB01=A, i know that is being used to provide coinsurance information.
similarly, i want to know what is the use of EB02=D.

Please help me

Thanks
Ajay

Response

EB01=D is to be used when none of the other EB01 values is appropriate and is used to indicate that additional benefit or service related information has been returned elsewhere in the 271 response 2110C/D, 2115C/D or 2120C/D loops. EB01=D itself does not have a meaning on its own. It is presumed that your request is regarding code value D in EB01 as EB02 does not have a value of D.
Submission 9/3/2010
Status Date 11/5/2010
Status F - Final
Primary References
Document 004010X092
Section3.1
Page219
Set IDEB01
Loop2110C
Segment IDEB
Element Position01