rbedi

Codes for EB01 - eligibility_or_benefit_information

Segments > EB > EB01

• 1 - :active_coverage
• 2 - :active__full_risk_capitation
• 3 - :active__services_capitated
• 4 - :active__services_capitated_to_primary_care_physician
• 5 - :active__pending_investigation
• 6 - :inactive
• 7 - :inactive__pending_eligibility_update
• 8 - :inactive__pending_investigation
• A - :coinsurance
• AA - :patient_reimbursement
• AB - :copayment_maximum
• AC - :coinsurance_maximum
• B - :copayment
• C - :deductible
• CB - :coverage_basis
• D - :benefit_description
• E - :exclusions
• F - :limitations
• G - :out_of_pocket_stop_loss
• H - :unlimited
• I - :noncovered
• J - :cost_containment
• K - :reserve
• L - :primary_care_provider
• M - :preexisting_condition
• MC - :managed_care_coordinator
• N - :services_restricted_to_following_provider
• O - :not_deemed_a_medical_necessity
• P - :benefit_disclaimer
• Q - :second_surgical_opinion_required
• R - :other_or_additional_payor
• S - :prior_years_history
• T - :cards_reported_loststolen
• U - :contact_following_entity_for_eligibility_or_benefit_information
• V - :cannot_process
• W - :other_source_of_data
• WV - :waiver
• X - :health_care_facility
• Y - :spend_down