Parent File | Name | Number | Package |
---|---|---|---|
EIV EICD TRACKING(#365.18) | INSURANCE DISCOVERED | 365.185 | Integrated Billing |
Field # | Name | Loc | Type | Details |
---|---|---|---|---|
.01 | PAYER VA ID | 0;1 | FREE TEXT |
|
.02 | PAYER NAME | 0;2 | FREE TEXT |
|
.03 | GROUP NUMBER | 0;3 | FREE TEXT |
|
.04 | SUBSCRIBER ID | 0;4 | FREE TEXT |
|
.05 | MEMBER ID | 0;5 | FREE TEXT |
|
.06 | SUBSCRIBER SSN | 0;6 | FREE TEXT |
|
.07 | INSURED DOB | 0;7 | DATE |
|
.08 | INSURED SEX | 0;8 | SET |
|
.09 | NAME OF INSURED | 0;9 | FREE TEXT |
|
.1 | SUBSCRIBER ADDRESS LINE 1 | 0;10 | FREE TEXT |
|
.11 | SUBSCRIBER ADDRESS LINE 2 | 0;11 | FREE TEXT |
|
.12 | SUBSCRIBER ADDRESS CITY | 0;12 | FREE TEXT |
|
.13 | SUBSCRIBER ADDRESS STATE | 0;13 | POINTER TO STATE FILE (#5) | STATE(#5)
|
.14 | SUBSCRIBER ADDRESS ZIP | 0;14 | FREE TEXT |
|
.15 | DEPENDENT POLICY (Y/N?) | 0;15 | SET |
|
1.01 | EICD VER INQ TRANSMISSION | 1;1 | POINTER TO IIV TRANSMISSION QUEUE FILE (#365.1) | IIV TRANSMISSION QUEUE(#365.1)
|
1.02 | EICD VER INQ DATE CREATED | 1;2 | DATE |
|
1.03 | EICD VER RESPONSE | 1;3 | POINTER TO IIV RESPONSE FILE (#365) | IIV RESPONSE(#365)
|
1.04 | EICD VER RESPONSE RESULT | 1;4 | SET |
|