Section title: Requests for Interpretation
RFI #
1901
271 Convey Group Funding Type
Description

How would you recommend we return information within the 271 advising the funding type of the group? We wish to convey to providers whether the group is Fully Insured or Self Insured. In looking at the IG it would appear we could add a MSG segment tied to the first EB active loop advising this. Do you have any other recommendations?

RFI Response

The MSG segment is the only option for this information based on guide 005010X279, and is recommended for interim use. For consistency, in response to your specific situation, it is further recommended that the contents of data item MSG01 contain either "FUNDING TYPE = FULLY INSURED" or "FUNDING TYPE = SELF INSURED".

The TR3 note # 2 states "It is highly recommended that the entity needing to use the MSG segment approach X12N with data maintenance to solve the long term business need, so the use of the MSG can be avoided for that issue."

Please submit a change request through http://changerequest.x12.org/ for this business need with detailed requirements.

DOCUMENT ID
005010X279