RE: 270/271 EB Segments - in and out of network deductibles

[Stuart Beaton]

Jan,
 
In order to identify that the deductible applies globally (regardless of in or out of 
network) you would not use EB12 at all.
 
EB12 does not validate whether the inquiring provider is in or out of network.  It is 
used to indicate that the information being relayed in the 2110 loop (the EB loop) 
applies, in or out of network.  If no information is relayed in EB12, the 2110 loop 
applies to in and out of network.
 
I hope this helps clarify EB12s use for you.
 
Stuart Beaton
Vice President
Washington Publishing Company
Co-Chair X12N/TG2/WG1 - Health Care Eligibility

        -----Original Message----- 
        From: Murphy-Hole, Jan [mailto:[EMAIL PROTECTED]] 
        Sent: Mon 7/1/2002 2:08 PM 
        To: '[EMAIL PROTECTED]' 
        Cc: 
        Subject: 270/271 EB Segments - in and out of network deductibles
        
        

        Is there any way to return deductible information in the 271 response that
        indicates the deductible applies to both in and out of network expenses?
        Unless I've missed it, I don't see an answer in the  EB segment.
        
        The EB12 data element is only used to validate whether the inquiring
        provider is considered in or out of network, is that  correct?
        
        Thank you!
        Jan Murphy-Hole
        EBIS-HIPAA
        Great-West Life & Annuity
        10T3
        303-737-3439
        email: [EMAIL PROTECTED]
        
        
        
        
        
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