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If you need immediate assistance, please contact Steven McGregor at (206) 901-7437, 
8-600-7437.  rm





>>> "[EMAIL PROTECTED]" 10/17/01 06:27 >>>

Our health plans would like to send back a 271 with more than the minimally
necessary "Yes, the patient is an eligible member today." 

If a 270 Health Care Eligibility Benefit Inquiry is requesting copay and
deductible amounts for a single service type or procedure code, is it
acceptable for the payor to return multiple EB segments with in-plan copay,
out-of-plan copay, in-plan deductible, out-of-plan deductible, etc.?  

I would like to hear if other managed care plans are determining whether
in-plan or out-of-plan apply upon receiving a 270 request or if all possible
benefits are sent in a 271.   Also how do providers feel about receiving 8
to 48 EB segments for a member inquiry. Thank you for your help.

Vicki Siegfried
Business Consultant
Coventry Health Care 
HIPAA / EDI Team
(724) 778-5931



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