271–5010 Health Care Eligibility Benefit Response - Subscriber Demographic Information and Subscriber Date –Loop 2100C

        

Subscriber Demographic Information.

Loop	Seg ID	Segment Name	Format	Length	Ref#	Req	Value
2100C	DMG	Demographic Information	ID	3		S	DMG
		Element Separator	AN	1			*
	DMG01	Date Time Period format Qualifier	ID	2	1250	S	D8 = Date format
		Element Separator	AN	1			*
	DMG02	Date Time Period	AN	8	1251	S	<CCYYMMDD - Recipient Date of Birth>
		Segment Terminator					~

Sample
DMG*D8*19571112

Loop	Seg ID	Segment Name	Format	Length	Ref#	Req	Value
2100C	DTP	Subscriber Date	ID	3		R	DTP
		Element Separator	AN	1			*
	DTP01	Date Time Qualifier	ID	2	374	R	See values below
		Element Separator	AN	1			*
	DTP02	Date Time Period Format Qualifier	ID	2/3	1250	R	D8 or RD8
		Segment Terminator					~

DTP 01 – Date Time Qualifier

 

Code	Definition
096	Discharge
102	Issue
152	Effective Date of Change
291	Plan
307	Eligibility
340	Consolidated Omnibus Budget Reconciliation Act (COBRA) Begin
341	Consolidated Omnibus Budget Reconciliation Act (COBRA) End
342	Premium Paid to Date Begin
343	Premium Paid to Date End
346	Plan Begin
347	Plan End
356	Eligibility Begin
357	Eligibility End
382	Enrolment
435	Admission
442	Date of Death
458	Certification
472	Service
539	Policy Effective
540	Policy Expiration
636	Date of Last Update
771	Status

DTP 02 – Date Time Period Qualifier

Code	Definition
D8	Date Expressed in Format CCYYMMDD
RD8	Range of Dates Expressed in Format CCYYMMDD-CCYYMMDD

Sample

DTP*356*D8*20110101
DTP*346*D8*20140101
DTP*347*D8*20141231

        

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