Information sources (payers) sometimes send 271 eligibility response transactions with "99991231" as the end of a date range. This technically complies with the CCYYMMDD format specification, but does it comply with the overall TR3 specification, and is it an appropriate business practice? For example, we received this segment in Loop ID-2100C:
DTP*291*RD8*20240101-99991231
We interpret that to mean that the plan end date is unknown or undefined, and that the subscriber has ongoing coverage. Is that the correct way to express the concept? Or if the plan end date is unknown then would it be more appropriate to just send a single plan begin date without a plan end date rather than using a default date, like this?
DTP*346*D8*20240101
We are receiving 271 transactions from payers and are unsure how to interpret them or whether they comply with the TR3 specification.
Currently, 005010X279A1 does not prohibit the use of end dates that are recognized as default dates.
There are often systematic limitations that force a date when one does not exist as the “from” and “to” (or “begin” and “end”) may be required in the membership systems. With that, the TR3 did not prohibit the default dates in the current version 005010X279A1. However, if no system limitation is in place requiring a “to” or “end” date, it is recommended no date be sent and only the begin date be shared. Any other date may cause confusion that it is a true/real end date, even if it is really a placeholder to satisfy a system requirement. Best practice is to inspect the data in the information source’s system, determine if the date is one that would or could be recognized as a default and suppress it from being returned.
In future versions of the 270/271, the use of default dates is prohibited.