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Back  RFI # 1291: 834 ID supplemental benefit

Formal vs. Informal Help Informal Formal

Submitter

Cathi Anderson

Description

Our compliance checker is failing the 834 when a 34 is reported in NM108 in combination with an A, B or C in the INS06-1. There appears to be some concern with accepting an SSN for Medicare enrollment.

HIR 1062 clearly indicates there is no issue with sending or receiving the SSN, since we are not a federally administered health plan. However, we are using the INS06-1 as the mechanism by which the employer indicates the type of product/benefits requested for the insured. If a Medicare supplemental policy is needed, this is the mechanism by which our groups report it.

Is this inaccurate? If not, please advise on the appropriate method for reporting to the payer the need for Medicare supplemental benefits.

Submitter Assigned Keywords

how to request Medicare supplemental benefits via 834

Response

As long as the enrollment is not in Medicare or another federal administered program such as CHAMPUS, then the SSN can be used even when reporting Medicare coverage in the INS06-1.
Submission 4/6/2011
Status Date 7/8/2011
Status F - Final
Primary References
Document 005010X220
Section2000 INS
Page47
Set IDINS06
Table2
Loop2000
Segment PositionINS06