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Plan Coverage Description (2100C-EB-05) - Registry Setting

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Avatar PM > Billing > Electronic Submissions > Eligibility Inquiry & Response (270/271)

'Y' enables the following:

  • The 'Plan Coverage Description (2110C-EB-05)' field replaces the 'Plan Coverage Description (2110C-EB-05-1)', 'Plan Coverage Description (2110C-EB-05-2)', 'Plan Coverage Description (2110C-EB-05-3)', and 'Plan Coverage Description (2110C-EB-05-4)' fields in the '271 Guarantor Mapping' form.
  • When a 271 file is posted in the 'Eligibility Response (271)' form, Loop 2110C Segment EB05 will be validated against the SYSTEM.plan_cover_eb_05_code SQL table to determine a 271 guarantor.

'N' disables the above logic, the 'Plan Coverage Description (2110C-EB-05)' field, and enables the 'Plan Coverage Description (2110C-EB-05-1)', 'Plan Coverage Description (2110C-EB-05-2)', 'Plan Coverage Description (2110C-EB-05-3)', and 'Plan Coverage Description (2110C-EB-05-4)' fields in the '271 Guarantor Mapping' form.