EDI Blog

(ASC X12) 1390 Eligibility or Benefit Information


Code identifying eligibility or benefit information


1 Active Coverage
2 Active – Full Risk Capitation
3 Active – Services Capitated
4 Active – Services Capitated to Primary Care Physician
5 Active – Pending Investigation
6 Inactive
7 Inactive – Pending Eligibility Update
8 Inactive – Pending Investigation
A Co-Insurance
B Co-Payment
C Deductible
D Benefit Description
E Exclusions
F Limitations
G Out of Pocket (Stop Loss)
H Unlimited
I Non-Covered
J Cost Containment
K Reserve
L Primary Care Provider
M Pre-existing Condition
N Services Restricted to Following Provider
O Not Deemed a Medical Necessity
P Benefit Disclaimer
Q Second Surgical Opinion Required
R Other or Additional Payor
S Prior Year(s) History
T Card(s) Reported Lost/Stolen
U Contact Following Entity for Eligibility or Benefit Information
V Cannot Process
W Other Source of Data
X Health Care Facility
Y Spend Down
CB Coverage Basis
MC Managed Care Coordinator

Appears in

EBEligibility or Benefit Information
Review post

Related Article

(EDIFACT) 7143 Item type identification code

TYPE=AN MIN= MAX=3 Coded identification of an item type. Codes (ICNCP) A code established by the International Code of 1) A 12-digit code that uniquely identifies the…

(ASC X12) 1495 Query Type Code

TYPE=ID MIN=1 MAX=1 Code indicating what information is provided in a query request Codes I Subshipment Chassis Identification N Railcar, Trailer or Container V Subshipment Vehicle Identification…

(ASC X12) 1653 Shipment Appointment Reason Code

TYPE=ID MIN=2 MAX=2 Code indicating the reason that a pick-up or delivery appointment status code was transmitted. Codes A1 Missed Delivery A4 Holiday, Closed A5 Appointment Already…

Leave a Reply

Your email address will not be published. Required fields are marked *