Hello,
I am creating a 271 for dental benefits. The problem I am encountering is that
we have 18 different benefit classifications (with potentially different copay
%, deductible, maximum, etc.) and there are only 13 service type codes that we
can match up for the EB03 value.
I am working with the business folks to map the 18 values to the 13 service
type codes as accurately as we can; however, it cannot be done without some
loss of information.
One of our trading partners has suggested that we leave the EB03 values blank
and use a MSG segment to supply the benefit class name. From what I can tell,
this is allowable but discouraged by the 271 implementation guide.
I am curious how others in the industry are addressing this issue. Are you
mapping with some information loss? Using free form text in a MSG segment?
Something else?
Kind regards,
Eric
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