RFI Browser

Back  RFI # 250: EB08 DE note

Formal vs. Informal Help Informal Formal

Submitter

chuck wilhelm

Description

The DE note states, " Use if eligibility or benefit must be qualified by a precentage; e.g., co-insurance." Was it the intent of the authors of the implementation guide that a value of zero or greater must be present when the EB01 data element value is equal to 'A' for co-insurance?

Response

The 004010X092/004010X092A1 Implementation Guide/ Addenda does not require a value of zero or greater in EB08 when EB01 is equal to ‘A’. The Implementation Guide encourages a value be returned, but does not explicitly require it. “Use if eligibility or benefit must be qualified by a percentage; e.g.,co-insurance.”

This has been changed for versions 4050 and 5010 of the Implementation Guide and would require a value of zero or greater in EB08 when EB01 is equal to ‘A’.
Submission 4/26/2005
Status Date 9/16/2005
Status F - Final
Primary References
Document 004010X092A1
Section3
Page306
Set ID271
Loop2110
Segment IDEB
Element Position08
Industry NameBenefit Precent