Hi Rhonda ~
Here's what we're doing for the INS03:
021 should be used when adding a new member
024 should be used when terminating ALL coverage on a member
001 should be used when changing an existing member
(including adding a new type of coverage or terminating an
individual type of coverage)
With Loop 2300, you would repeat it (up to 99 times) for each type of
coverage involved in the transaction. This could be enrolling a member in
multiple types of coverage, or a combination of adding/changing/cancelling
coverages. However, if you are terminating ALL coverage, Loop 2300 is not
suppose to be included. An 024 in the INS03 is suppose to handle this
situation. (See page 13 of the IG under 2.5 Terminations)
Hope this helps!
-----Original Message-----
From: Armstrong, Rhonda [mailto:[EMAIL PROTECTED]]
Sent: Wednesday, October 09, 2002 8:38 AM
To: '[EMAIL PROTECTED]'
Cc: '[EMAIL PROTECTED]'
Subject: FW: 834 Transaction - Policy Number
Hello Judy O'Dell and Wedi,
I have a question about the following elements in the 834 IG and how you
would use them.
INS03 Maintenance Type Code.
When we are making a change to an existing subscriber/dependent record we
use 001
When we are adding a subscriber or dependent we use 021
When we term,cancel or delete a subscriber or dependent we use 024
We were told by a vendor that they can use 001 for changes, adds or deletes
in the INS03 and this is compliant usage (the same change code 001 for all
three actions). How do you use this segment?
HD Loop
One other question, The Health Coverage Loop...do you repeat this loop when
there is additional coverage for a subscriber (i.e. when enrolling an
employee with multiple health care products such as health, dental and
vision).
I really appreciate you sharing your knowledge.
Thank you,
Rhonda Armstrong
HIPAA Project Manager
1-267-402-1651
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