EQ Eligibility or Benefit Inquiry

Batch

To specify inquired eligibility or benefit information

Elements

PositionElementNameTypeMin/MaxRepeat
C064Service TypeRel
99
C003Composite Medical Procedure IdentifierRel
99
31207Coverage Level CodeOptID3/31
41788Insurance Product CodeOptID1/31
51328Diagnosis Code PointerOptNumber1/212
61791Network Indicator CodeOptID1/21

Element Details

ID1207
NameCoverage Level Code
LengthMin 3 / Max 3
Position3
RequirementOpt
Codes
  • <>E5D
    Employee and One or More Dependents
  • <>SPO
    Spouse Only
  • <>E6D
    Employee and Two or More Dependents
  • <>E3D
    Employee and Three Dependents
  • <>SS5
    Subscriber, spouse, and 1 or more children
  • <>S5C
    Subscriber and 1 or more children
  • <>E9D
    Employee and Five or More Dependents
  • <>EMP
    Employee Only
  • <>SPC
    Spouse and Children
  • <>SS6
    Subscriber, spouse, and 2 or more children
  • <>E7D
    Employee and Three or More Dependents
  • <>ESP
    Employee and Spouse
  • <>TWO
    Two Party
  • <>CHD
    Children Only
  • <>FAM
    Family
  • <>SSP
    Subscriber and spouse
  • <>E1D
    Employee and One Dependent
  • <>E2D
    Employee and Two Dependents
  • <>IND
    Individual
  • <>ECH
    Employee and Children
  • <>S6C
    Subscriber and 2 or more children
  • <>S1C
    Subscriber and 1 child
  • <>SS1
    Subscriber, spouse, and 1 child
  • <>E8D
    Employee and Four or More Dependents
  • <>DEP
    Dependents Only