EQ Eligibility or Benefit Inquiry
EQ Eligibility or Benefit Inquiry
To specify inquired eligibility or benefit information
Position
Element
Name
Type
Requirement
Min
Max
Repeat
EQ-01
Conditional
-
Position of data in the repeating data element conveys no significance.
EQ-02
Conditional
-
Position of data in the repeating composite data element conveys no significance.
EQ-03
Coverage Level Code
Identifier (ID)
Optional
3
3
-
Code indicating the level of coverage being provided for this insured
EQ-04
Insurance Product Code
Identifier (ID)
Optional
1
3
-
Code identifying the type of insurance policy within a specific insurance program for eligibility purposes.
EQ-05
Diagnosis Code Pointer
Numeric (N0)
Optional
1
2
-
A pointer to the diagnosis code in the order of importance to this service
The first pointer designates the primary diagnosis and remaining diagnosis pointers indicate declining level of importance.
EQ-06
Network Indicator Code
Identifier (ID)
Optional
1
2
-
Code identifying a health plan network status.