This Draft Standard for Trial Use contains the format and establishes the data contents of the Health Care Eligibility/Benefit Inquiry Transaction Set (270) for use within the context of an Electronic Data Interchange (EDI) environment. This transaction set can be used to inquire about the health care eligibility and benefits associated with a subscriber or a dependent under the subscriber's policy. A subscriber is a person who elects the benefits and is affiliated with the employer or the insurer. A dependent is a person who is affiliated with the subscriber such as spouse, child, etc., and therefore may be entitled to benefits.
To indicate the start of a transaction set and to assign a control number
To indicate the beginning of a transaction set.
To identify dependencies among and the content of hierarchically related groups of data segments.
To uniquely identify a transaction to an application.
To supply the full name of an individual or organizational entity
To specify identifying numbers.
To specify additional names or those longer than 35 characters in length
To specify the location of the named party
To specify the geographic place of the named party
To identify a person or office to whom administrative communications should be directed
To specify the identifying characteristics of a provider
To supply demographic information
To provide benefit information on insured entities
To specify any or all of a date, a time, or a time period
To specify inquired eligibility or benefit information
To specify identifying numbers.
To specify any or all of a date, a time, or a time period
To indicate the end of the transaction set and provide the count of the transmitted segments (including the beginning (ST) and ending (SE) segments).
