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270 / 271 / 834 Section - Cal-PM

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Define 270/271/834 settings.

Health Care Eligibility Benefit Inquiry And Response (270/271)

  1. In the Support 270/271 Transaction Sets field, select whether or not to enable 270/271 support for the selected guarantor.
  2. In the Skip Liability Update Process If No Valid Response (271) Received For An Inquiry (270) field, select whether or not to skip the update process when there is no response.
  3. In the Prevent 271 From Updating 'Eligibility Verified' If Eligibility Has Already Been Verified field, select whether or not a 271 response indicating a loss of eligibility should NOT update the Eligibility Verified field in the Financial Eligibility form.

Health Care Eligibility Benefit Inquiry (270)

  1. In the Number Of Days From The 270 Submission Through Date To A Client's Discharge Date For Which The Client Should Be Excluded From 270 Submission field, enter the number of days.
  2. In the Include Rendered Services in 270 field, select the operational rule for rendered services.
  3. In the Include Scheduled Services/Appointments In 270 field, select the operational rule for scheduled services.
  4. In the Exclude Rendered Services From 270 If Liability Does Not Distribute To Guarantor field, select whether or not to omit the services.
  5. In the If The GS Segment Information For A Particular Guarantor Is The Same For All Program Combinations, Do You Want To Create A Single GS Segment For That Guarantor field select whether or not to combine a guarantor's GS segment information.
  6. In the If Creating A Single GS Segment For A Particular Guarantor, Do You Want To Create A Single ST Segment For That Guarantor field, select whether or not to combine a guarantor's ST segment information as well.

Health Care Eligibility Benefit Response (271)

  1. In the Information Source Identification Code Qualifier (2100A-NM1-08) field, select the qualifier.
  2. In the Information Source Primary Identifier (2100A-NM1-09) field, enter the primary identifier.
  3. In the Default Expiration Date (2100C/2100D-DTP-02) field, select the date.
  4. In the Subscriber Release Of Information field, select whether or not the subscriber has authorized release of information.
  5. In the Subscriber Assignment Of Benefits field, select whether or not the subscriber has assigned benefits.
  6. In the Add Or Purge Eligibility Tables field, select whether the 271 compile process should only update a client's data in the eligibility table if that data does not exist in the table (Add), or update a client's data in the eligibility table regardless of preexisting data (Purge).
  7. In the Validate Guarantor via myAvatar Eligibility Tables field, select whether or not to validate the selected guarantor through the eligibility tables.