File IIV_RESPONSE(365) Data List
| MESSAGE CONTROL ID |
PATIENT |
PAYER |
BUFFER ENTRY |
TRANSMISSION QUEUE |
TRANSMISSION STATUS |
DATE/TIME RECEIVED |
DATE/TIME CREATED |
TRACE NUMBER |
RESPONSE TYPE |
DO NOT PURGE |
INSUR RECORD IEN |
EIV AUTO-UPDATE |
REQUESTED SERVICE DATE |
REQUESTED SERVICE TYPE CODE |
*NAME OF INSURED |
INSURED DOB |
INSURED SSN |
INSURED SEX |
*SUBSCRIBER ID |
*GROUP NAME |
*GROUP NUMBER |
WHOSE INSURANCE |
PT RELATIONSHIP TO INSURED |
SERVICE DATE |
EFFECTIVE DATE |
EXPIRATION DATE |
COORDINATION OF BENEFITS |
ERROR CONDITION |
ERROR ACTION |
DATE OF DEATH |
CERTIFICATION DATE |
MEMBER ID |
PAYER UPDATED POLICY |
POLICY NUMBER |
GROUP PROVIDER INFO |
HEALTH CARE CODE INFORMATION |
MILITARY INFO STATUS CODE |
MILITARY EMPLOYMENT STATUS |
MILITARY GOVT AFFILIATION CODE |
MILITARY PERSONNEL DESCRIPTION |
MILITARY SERVICE RANK CODE |
DATE TIME PERIOD FORMAT QUAL |
DATE TIME PERIOD |
NAME OF INSURED |
SUBSCRIBER ID |
GROUP NAME |
GROUP NUMBER |
ELIGIBILITY/BENEFIT |
CONTACT PERSON |
ERROR TEXT |
SUBSCRIBER ADDRESS LINE 1 |
SUBSCRIBER ADDRESS LINE 2 |
SUBSCRIBER ADDRESS CITY |
SUBSCRIBER ADDRESS STATE |
SUBSCRIBER ADDRESS ZIP |
SUBSCRIBER ADDRESS COUNTRY |
SUBSCRIBER ADDRESS SUBDIVISION |
REJECT REASONS |
SUBSCRIBER DATES |
PT. RELATIONSHIP - HIPAA |
GROUP REFERENCE INFORMATION |