RE: 270 Eligibility Subscriber - Dependent loop.

[Hal Scoggins]

Deepan,   I can't find any mention in the 270/271 IG of putting the Dependent info at the Subscriber level if he is uniquely identified. The only transaction I know of that allows this is the 278. Can you direct me to the text in the IG that you read as allowing this?   As to your questions, here are my opinions, for what they're worth...   1) IMO, it is not appropriate to put the Dependent info at the Subscribed level in any situation.   2) I would expect the Member ID to be printed on the ID card, even if the Insurance co. (illegally) uses the SSN.   3) This is closely related to #1. As I said, it is my opinion that there should always be two HLs if the Patient is a Dependent.   4) I pass on this one.   I'll be interested to hear any other opinions.   Hal Scoggins SBPA Systems, Inc. (281) 679-7272 x116 -----Original Message----- From: Deepan Vashi [mailto:[EMAIL PROTECTED]] Sent: Monday, June 17, 2002 9:41 PM To: [EMAIL PROTECTED]; [EMAIL PROTECTED] Subject: 270 Eligibility Subscriber - Dependent loop. Hi friends:   May be this was addressed earlier : 270 Eligibility Subscriber - Dependent loop.   In Transaction set 270.  There are two levels for Subscriber and Dependent information.   If subscriber is the patient then dependent HL will not come. But if subscriber is other than patient dependent HL is required.   As per IG if patient(dependent) is not a subscriber however dependant can be uniquely identified (with Member Id) by insurance company, patient (dependent) information will come at Subscriber Level.   My questions are: 1) Is it necessary(mandatory) to keep dependent information in the subscriber level if he can be uniquely identified   2) Is this "Unique Id" for patient defined by insurance company and printed on the insurance Card of the dependent member?  or  some Insurance Companies use SSN, EIN or some other id.   Note: In 837P (IG page No: 119)Member ID (MI) can only be one of : Subscriber Id, Patient Id, Health Insurance Claim Number   3) Suppose a company provides unique id to each patient, regardless of whether he/she is a subscriber or patient.  In such case can Insurance company ask for two HLs to come in 270? (Subscriber and Patient  HL both).   4) If there are 2 approaches to 270 transaction, is it left to trading partners to decide the method of implementation?     Your views on above will be highly appreciated.   Thanks and regards   Deepan Vashi