Section title: Requests for Interpretation
RFI #
2351
Return plan premium in a 271
Description

We have a payer who is asking if it would be possible to return plan premium in the 271.

The 270/217 (Eligibility Request/Response) does not provide a specific "plan level" designation for the premium for a plan. It is possible to contrive a 2110 loop as follows, the EB01 value of 1 for Active Coverage, EB02 for Individual, EB05 for plan description EB06 for contract, EB07 for premium amount, Adding REF01 (18) for plan number, DTP01 (291) for plan dates and a MSG segment indicating that the values are for displaying the premium.

EB*1*IND*30**SOLE CARRIER*25*3000~
REF*18*plan number~
DTP*291*RD8*startdate-stopdate~
MSG*ANNUAL PREMIUM~

It appears that this may be an acceptalbe approach and I was hoping that you may be able to verify or offer another option

Response

Based on the described scenario we do not believe the 270\271 can accommodate this business need.   Please submit a maintenance request to http://changerequest.x12.org 

DOCUMENT ID
005010X279A1