We have a need to submit newborn demographic data as part of a request for newborn services, since the plan doesn't have the newborn's patient information yet. There doesn't seem to be any way to provide this information on the 278 - do you have a recommendation?
Clarifying question from WG10: Could you clarify if the question is around the submission of the newborn data (the 278 already supports capturing of this data) to the plan or how the plan processes this info on the 278 received when the plan may not have the data?
First response: I’m asking about submission of newborn data – how does the 278 support this?
Second response: I’m really looking for guidance on the submission of newborn data, do you have any recommendation? I am currently planning on using the dependent loop (2010D), however I am a little concerned for the case where the parent is not the subscriber.
For example we validate patient eligibility using the 270/271. In this case I’m expecting the user to search for the mother. However if the mother is a dependent, I will essentially need to replace the mother with the new baby in the dependent loop when creating the 278. Does this sound correct?
If the newborn child has or will have a unique member ID, the newborn information is submitted in the 2000C subscriber loop only. If the newborn child will fall under the member ID of the subscriber, then the newborn information is submitted in the 2000D loop.
Recommendation:
If the newborn is a dependent, the submitter could use the INS segment in the dependent loop (2000D) to further identify the relationship between the subscriber and the newborn baby.