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Back  RFI # 157: INS data validation

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Submitter

Angela Hendrix

Description

INS06 This element is REQUIRED if a member is being enrolled or disenrolled in Medicare, is currently enrolled in Medicare or has
terminated or changed their Medicare enrollment. (Is this best validated with DTP (Member Level Dates) DTP01 codes 338 and 339?)

INS07 This element is REQUIRED if a member is being enrolled in or is enrolled for a benefit covered by COBRA. (Is this better validated by INS05 = C or if DTP Member Level Date DTP01 = 301, 340, or 341?)

Submitter Assigned Keywords

INS enrolled

Response

Since the DTP dates occur after the INS06 element, INS06 would be used to validate the presence of the dates, not the other way around. Since INS05 occurs before INS07, it is the appropriate validator for the INS07 element, and the subsequent related DTP. Inconsistencies between the elements indicate a problem, not which information is correct.
Submission 12/1/2004
Status Date 1/21/2005
Status F - Final
Primary References
Document 004010X095A1
SectionDetail
Page48
Set ID834
Table2
Loop2000
Segment Position010
Segment IDINS