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Back  RFI # 326: 834 2100A AMT

Formal vs. Informal Help Informal Formal

Submitter

Bruce Saunders

Description

In the 834 (Benefit Enrollment and Maintenance) EDI standard, if an entity wants to send premium information would they use the AMT segment in the 2100A loop?

Response

This issue is explicitly addressed in guide 004010X095. Transmission of a Member specific total premium amount is possible in the 2100A loop, AMT segment using AMT01 qualifier P3. Transmission of a Health Coverage specific Premium amount for a Member is possible in the 2300 loop AMT segment using AMT01 qualifier P3. In both cases, the segment note states "This data should only be transmitted when such transmission is required under the insurance contract between the sponsor and payer." Therefore, under this implementation guide, either location can be used to send premium information, but only if required under the insurance contract between the sponsor and the payer.
Submission 9/20/2005
Status Date 9/21/2005
Status F - Final
Primary References
Document 004050X125
Section3.4
Page87
Set ID834
Loop2100A
Segment PositionAMT