CSI Claim Status Information

Batch

To indicate the status of a claim for mortgage insurance benefits

Elements

PositionElementNameTypeMin/MaxRepeat
11383Claim Submission Reason CodeMandatoryID2/21
2374Date/Time QualifierMandatoryID3/31
31250Date Time Period Format QualifierMandatoryID2/31
41251Date Time PeriodMandatoryAlphanumeric1/351

Element Details

ID1383
NameClaim Submission Reason Code
LengthMin 2 / Max 2
Position1
RequirementMandatory
Codes
  • <>15Resubmission
  • <>07Duplicate
  • <>28Late Charges
  • <>22Information Copy
  • <>00Original
  • <>29Adjustment
  • <>17Cancel to be Reissued
  • <>01Cancellation
  • <>18Reissue
  • <>16Proposed
  • <>20Final Transmission
  • <>PBPredetermination of Dental Benefits
  • <>02Corrected and Verified Original Claim
  • <>27Verify
  • <>05Replace
  • <>08Pre-Determination
  • <>03Corrected and Verified Final Claim
  • <>09Encounter