属性

数据类型ID

必须?Mandatory

Codes (42)

• 1Active Coverage
• 2Active - Full Risk Capitation
• 3Active - Services Capitated
• 4Active - Services Capitated to Primary Care Physician
• 5Active - Pending Investigation
• 6Inactive
• 7Inactive - Pending Eligibility Update
• 8Inactive - Pending Investigation
• 9Coverage Never Activated
• ACo-Insurance
• BCo-Payment
• CDeductible
• DBenefit Description
• EExclusions
• FLimitations
• GOut of Pocket (Stop Loss)
• HUnlimited
• INon-Covered
• JCost Containment
• KReserve
• LPrimary Care Provider
• MPre-existing Condition
• NServices Restricted to Following Provider
• ONot Deemed a Medical Necessity
• PBenefit Disclaimer
• QSecond Surgical Opinion Required
• ROther or Additional Payor
• SPrior Year(s) History
• TCard(s) Reported Lost/Stolen
• UContact Following Entity for Eligibility or Benefit Information
• VCannot Process
• WOther Source of Data
• XHealth Care Facility
• YSpend Down
• AAPatient Reimbursement
• ABCo-payment Maximum
• ACCo-insurance Maximum
• CBCoverage Basis
• MCManaged Care Coordinator
• SBShared Benefit Limitation
• SDShared Benefit Deductible
• WVWaiver