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Guarantor/Program Billing Defaults - Eligibility Inquiry (270) Section - Cal-PM

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Set the default 270 billing file values. This information must be entered to process a 270 file.

  • This section is enabled through the Enable 270/271 Transaction Sets registry setting.

Interchange Control Header (ISA)

  1. In the Authorization Information Qualifier (ISA-01) field, choose the authorization information category/type.

  2. In the Authorization Information (ISA-02) field, type the authorization information to include in the 270 file.

  3. In the Security Information Qualifier (ISA-03) field, select the type of security information requested. The value populates the ISA-03 segment.

  4. In the Security Information (ISA-04) field, type the security information to include in the 270 file.

  5. In the Interchange ID Qualifier (ISA-05) field, select the interchange ID category. The value chosen here populates the ISA-05 segment.

  6. In the Interchange Sender ID (ISA-06) field, type the sender ID to include in the 270 file.

  7. In the Interchange ID Qualifier (ISA-07) field, select the value, which populates the ISA-07 segment.

  8. In the Interchange Receiver ID (ISA-08) field, type the receiver ID to include in the 270 file.

  9. In the Acknowledgement Requested (ISA-14) field, denote whether acknowledgement will be requested from the interchange receiver. The value populates the ISA-14 segment.

  10. In the Usage Indicator (ISA-15) field, select the data usage.

Function Group Header (GS)

  1. In the Application Senders Code (GS-02) field, type the sender's code.

  2. In the Applications Receiver Code (GS-03) field, type the receiver's code.

Information Source Name (2100A-NM1)

  1. In the Entity Identifier Code (2100A-NM1-01) field, select the value for the entity ID code.

  2. In the Entity Type Qualifier (2100A-NM1-02) field, choose an entity type.

  3. In the Information Source Last Or Organization Name (2100A-NM1-03) field, type the information source name (surname or organization/agency name).

  4. In the Identification Code Qualifier (2100A-NM1-08) field, select the ID code type.

  5. In the Information Source Primary Identifier (2100A-NM1-09) field, type the information source primary identifier.

Information Receiver Level (2100B-HL)

  1. In the Entity Identifier Code (2100B-NM1-01) field, select the value for the entity ID code.

  2. In the Entity Type Qualifier (2100B-NM1-02) field, choose an entity type.

  3. In the Information Receiver Last Or Organization Name (2100B-NM1-03) field, type the information source name (surname or organization/agency name).

  4. In the Identification Code Qualifier (2100B-NM1-08) field, select the ID code type.

  5. In the Information Receiver Identification Number (2100B-NM1-09) field, enter the information receiver ID number.

Information Receiver Additional Identification (2100B-REF)

  1. In the Reference Identification Qualifier (2100B-REF-01) field, select the reference ID type.

  2. In the Information Receiver Additional Identifier (2100B-REF-02) field, type the information receiver additional identifier.

  3. In the License Number State Code (2100B-REF-03) field, type the two-letter license number state code.

Information Receiver Address (2100B-N3)

  1. In the Information Receiver Address Line (2100B-N3-01) field, type the information receiver address.

  2. In the Information Receiver Additional Address Line (2100B-N3-02) field, type the information receiver additional address.

Information Receiver City/State/ZIP Code (2100B-N4)

  1. In the Information Receiver Postal Zone Or ZIP Code (2100B-N4-03) field, enter the postal zone/ZIP code for the information receiver.

  2. In the Information Receiver City Name (2100B-N4-01) field, type the information receiver's city.

  3. In the Information Receiver State Code (2100B-N4-02) field, select the information receiver's state.

Information Receiver Contact Information (2100B-PER)

  1. In the Information Receiver Contact Name (2100B-PER-02) field, type the information receiver contact name.

  2. In the Communication Number Qualifier (2100B-PER-03) field, select the communication number category/type.

  3. In the Information Receiver Communication Number (2100B-PER-04) field, type the information receiver communication number.

  4. In the Communication Number Qualifier (2100B-PER-05) field, select the communication number category/type.

  5. In the Information Receiver Communication Number (2100B-PER-06) field, type the information receiver communication number.

  6. In the Communication Number Qualifier (2100B-PER-07) field, select the communication number category/type.

  7. In the Information Receiver Communication Number (2100B-PER-08) field, type the information receiver communication number.

Information Receiver Provider Information (2100B-PRV)

  1. In the Provider Code (2100B-PRV-01) field, select the provider code category/type.

  2. In the Receiver Provider Specialty Code (2100B-PRV-03) field, type the receiver provider specialty code.

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