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Back  RFI # 1400: 270 Subscriber/ Dependent DTP

Formal vs. Informal Help Informal Formal

Submitter

Peter Anderson

Description

The 2100C Subscriber DTP TR3 note #3 indicates the 291 (Plan) dates apply to all the EQ loops that follow, unless a different date is specified in the EQ loop. Does that include the Dependent EQ loops that follow or only the Subscriber EQ loops?

If the Subscriber Plan dates do apply to the Dependent EQ loops, we have an additional question. The 2100D Dependent DTP TR3 note #1 indicates that the absence of a Plan date indicates the request is for the date the transaction is processed. Does this implied date override the 2100C Subscriber DTP Date?

For example:
2100C (Subscriber):DTP*291*RD8*20110101-20110728~
2110C (Subscriber EQ): Not submitted
2100D (Dependent DTP): Not submitted
2110D (No Dependent 2110D DTP):EQ*1~

In this example should the 271 response for the dependent be based on the subscriber DTP or on the current processing date?

Submitter Assigned Keywords

270 DTP

Response

2100C DTP Situational Rule states “Required when the information receiver wishes to convey the plan date(s) for the subscriber in relation to the eligibility/benefit inquiry.”
Note 3 states “When using code “291" (Plan) at this level, it is implied that these dates apply to all of the Eligibility or Benefit Inquiry (EQ) loops that follow.” 2100C DTP dates do not apply to the 2100D loop since the Situational rule indicates that these dates apply to the subscriber.

If there are no dates in the 2100D loop, the date the transaction is process will be used. If a date was sent in the 2100C loop, it will be ignored for the 2100D loop.

In the example provided, the date the transaction is processed would be used for the 2110D EQ.
Submission 9/8/2011
Status Date 1/4/2012
Status F - Final
Primary References
Document 005010X279
Section2.4
Page124
Set ID270
Table2
Loop2100C
Segment Position1200
Segment IDDTP
Secondary References
RFI ID 1846
Document 005010X279
Section2.4
Page181
Set ID270
Table2
Loop2100D
Segment Position1200
Segment IDDTP