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Back  RFI # 249: EB07 monetary amount issue

Formal vs. Informal Help Informal Formal

Submitter

chuck wilhelm

Description

The data element note states, "Use if eligibility or benefit must be qualified by a monetary amount; e.g., deductible, co-payment. Was it the intent of the autors of the guide that this note indicate that a value of zero or greater must be present in this field when EB01 is equal to 'C' or 'B' respectively?

Response

The 004010X092/004010X092A1 Implementation Guide/ Addenda does not require a value of zero or greater in EB07 when EB01 is equal to ‘C’ or ‘B’. The Implementation Guide encourages a value be returned, but does not explicitly require it. “Use if eligibility or benefit must be qualified by a monetary amount; e.g., deductible, co-payment.”

This has been changed for versions 4050 and 5010 of the Implementation Guide and would require a value of zero or greater in EB07 when EB01 is equal to ‘B’, ‘C’, ‘G’, ‘J’ or ‘Y’.
Submission 4/26/2005
Status Date 9/16/2005
Status F - Final
Primary References
Document 004010X092A1
Section3
Page305
Set ID271
Loop2110
Segment IDEB
Element Position07
Industry NameBenefit Amount