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Back  RFI # 878: 834 Medicare Effective Dates

Formal vs. Informal Help Informal Formal

Submitter

Penny Probst

Description

We currently use the 834 to report a member's enrollment in Medicare using the INS segment and related DTP segment for the effective date. If we need to report that a member has additional insurance of both Medicare Part A and Medicare Part B, but each with different effective dates, how would that be reported?

Response

The Workgroup’s recommended workaround is to report that a member has additional insurance for both Medicare Part A and Medicare Part B by using two iterations of the 2320 loop, one for each additional insurance. Each iteration should contain the HIB/HIC number within the COB02 to indicate Medicare coverage, N102 should reference “Medicare Part A” or “Medicare Part B”, and the corresponding 2320 loop DTP01 should reference “344” for Coordination of Benefits Begin or “345” for Coordination of Benefit End.
Submission 10/7/2009
Status Date 2/26/2010
Status F - Final
Primary References
Document 004010X095A1
SectionINS
Page48
Set ID834