Element
X12 EDI Release 00503
EB
1390Eligibility or Benefit Information Code
Code identifying eligibility or benefit information
属性
数据类型ID
必须?Mandatory
Codes (41)
  • 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
  • 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