PACIFIC SOURCE HEALTH PLAN (247) PAYER (365.12)
Name
Value
PAYER NAME
PACIFIC SOURCE HEALTH PLAN
VA NATIONAL ID
VA965
EDI ID NUMBER - PROF
93029
EDI ID NUMBER - INST
93029
APPLICATION
EIV
NATIONALLY ENABLED: Enabled
*AUTO-ACCEPT: YES
*IDENT REQUIRES SUBSCRIBER ID: NO
*TRANSMIT SSN: NO
DATE/TIME CREATED: 2016-10-28 15:06:20
*FUTURE SERVICE DAYS: 60
*PAST SERVICE DAYS: 365
AUTO-UPDATE: YES
270 REQUIRES SUB ID: NO
FUTURE SERVICE DAYS: 60
PAST SERVICE DAYS: 365