As part of our health plan implementation for HIPAA, we plan to begin using the 271 first as an unsolicited roster to replace the eligibility file we currently send to our trading partners. During the process of mapping our current file to the 271, we have discovered that there are a number of fields we currently send to our trading partners that are not accomodated on the 271. We are in the process of evaluating the affect of the absence of these fields on the process of doing business with our trading partners. However, we are wondering if others are finding the same issues and what conclusions they are drawing.
Examples of some of the fields not included in the 271 are:
- a transaction code indicating that the record is an add, update, term, or unchanged record.
- A relationship code indicating the member's relationship to the subscriber
- A termination reason code
- A product line indicator
- A current benefit package indicator
- Rider type code (multiple indicators)
- PCP provider group affiliation
- Other coverage carrier indicator
Are other organizations encountering similar issues? If so, how are you resolving them?
Thanks,
Ellen Tatge
IS Project Manager
Presbyterian Healthcare Services
505/923-6882
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