EDI 269 Segments and Elements for the Health Care Benefit Coordination Verification Standard


AgencySet IDFGTransaction DescriptionSubcommitteeStandard
ANSI269HVHealth Care Benefit Coordination Verification InsuranceDownload


Online EDI 269 Translation      More about 269s   269 Mapping Specs   Need Help?

Research and Development:
See the list of EDI 269 segments and elements in below data grid. The Jobisez.com site has an online translation tool that converts the EDI 269 (Health Care Benefit Coordination Verification) document into a CSV file. If you are researching the 269s, you can view other trading partner's mapping specifications. You can also gain knowledge by researching all EDI document types. Jobisez LLC can also provide assistance if you need additional help.

Solutions:
Are you looking to trade the EDI 269 transaction with one of your trading partners? Do you need an EDI VAN Savings solution to exchange the 269? Or perhaps you would like to use a Cloud-Based application, so you can plug your 269 transaction directly into your ERP and TMS systems. Even small companies have the ability to trade the EDI 269 by using the EDI Mobile Device solution.


The EDI 269 Segments and Elements

SegmentDescriptionSectReqMax LoopMax UsagePos
BGNBeginning SegmentHM011
N1Party IdentificationHM212
N2Additional Name InformationHO013
N3Party LocationHO014
N4Geographic LocationHO015
PERAdministrative Communications ContactHO016
TRNTraceDM99999917
CLPClaim Level DataDO018
DTPDate Or Time Or PeriodDO029
AAARequest ValidationDO0110
NM1Individual Or Organizational NameDO4111
N2Additional Name InformationDO0112
N3Party LocationDO0113
N4Geographic LocationDO0114
REFReference InformationDO0915
PERAdministrative Communications ContactDO0116
DTPDate Or Time Or PeriodDO0117
SVCService InformationDO999118
DTPDate Or Time Or PeriodDO0119


SegmentElementDescriptionReqMin LengthMax LengthType
BGN1Transaction Set Purpose CodeM22ID
BGN2Reference IdentificationM150AN
BGN3DateM88DT
BGN4TimeC48TM
BGN5Time CodeO22ID
BGN6Reference IdentificationO150AN
BGN7Transaction Type CodeO22ID
BGN8Action CodeO12ID
BGN9Security Level CodeO22ID
N11Entity Identifier CodeM23ID
N12NameC160AN
N13Identification Code QualifierC12ID
N14Identification CodeC280AN
N15Entity Relationship CodeO22ID
N16Entity Identifier CodeO23ID
N21NameM160AN
N22NameO160AN
N31Address InformationM155AN
N32Address InformationO155AN
N41City NameO230AN
N42State Or Province CodeC22ID
N43Postal CodeO315ID
N44Country CodeC23ID
N45Location QualifierC12ID
N46Location IdentifierO130AN
N47Country Subdivision CodeC13ID
PER1Contact Function CodeM22ID
PER2NameO160AN
PER3Communication Number QualifierC22ID
PER4Communication NumberC1256AN
PER5Communication Number QualifierC22ID
PER6Communication NumberC1256AN
PER7Communication Number QualifierC22ID
PER8Communication NumberC1256AN
PER9Contact Inquiry ReferenceO120AN
TRN1Trace Type CodeM12ID
TRN2Reference IdentificationM150AN
TRN3Originating Company IdentifierO1010AN
TRN4Reference IdentificationO150AN
CLP1Claim Submitter's IdentifierM138AN
CLP2Claim Status CodeM12ID
CLP3Monetary AmountM118R
CLP4Monetary AmountM118R
CLP5Monetary AmountO118R
CLP6Claim Filing Indicator CodeO12ID
CLP7Reference IdentificationO150AN
CLP8Facility Code ValueO12AN
CLP9Claim Frequency Type CodeO11ID
CLP10Patient Status CodeO12ID
CLP11Diagnosis Related Group (Drg) CodeO14ID
CLP12QuantityO115R
CLP13Percentage As DecimalO110R
CLP14Yes/No Condition Or Response CodeO11ID
DTP1Date/Time QualifierM33ID
DTP2Date Time Period Format QualifierM23ID
DTP3Date Time PeriodM135AN
AAA1Yes/No Condition Or Response CodeM11ID
AAA2Agency Qualifier CodeO22ID
AAA3Reject Reason CodeO22ID
AAA4Follow-Up Action CodeO11ID
NM11Entity Identifier CodeM23ID
NM12Entity Type QualifierM11ID
NM13Name Last Or Organization NameC160AN
NM14Name FirstO135AN
NM15Name MiddleO125AN
NM16Name PrefixO110AN
NM17Name SuffixO110AN
NM18Identification Code QualifierC12ID
NM19Identification CodeC280AN
NM110Entity Relationship CodeC22ID
NM111Entity Identifier CodeO23ID
NM112Name Last Or Organization NameO160AN
N21NameM160AN
N22NameO160AN
N31Address InformationM155AN
N32Address InformationO155AN
N41City NameO230AN
N42State Or Province CodeC22ID
N43Postal CodeO315ID
N44Country CodeC23ID
N45Location QualifierC12ID
N46Location IdentifierO130AN
N47Country Subdivision CodeC13ID
REF1Reference Identification QualifierM23ID
REF2Reference IdentificationC150AN
REF3DescriptionC180AN
REF4Reference Identification QualifierO23ID
REF5Reference IdentificationO150AN
REF6Reference Identification QualifierO23ID
REF7Reference IdentificationO150AN
REF8Reference Identification QualifierO23ID
REF9Reference IdentificationO150AN
PER1Contact Function CodeM22ID
PER2NameO160AN
PER3Communication Number QualifierC22ID
PER4Communication NumberC1256AN
PER5Communication Number QualifierC22ID
PER6Communication NumberC1256AN
PER7Communication Number QualifierC22ID
PER8Communication NumberC1256AN
PER9Contact Inquiry ReferenceO120AN
DTP1Date/Time QualifierM33ID
DTP2Date Time Period Format QualifierM23ID
DTP3Date Time PeriodM135AN
SVC1Product/Service Id QualifierM22ID
SVC2Product/Service IdM148AN
SVC3Procedure ModifierM22AN
SVC4Procedure ModifierM22AN
SVC5Procedure ModifierM22AN
SVC6Procedure ModifierM22AN
SVC7DescriptionM180AN
SVC8Product/Service IdM148AN
SVC9Monetary AmountM118R
SVC10Monetary AmountO118R
SVC11Product/Service IdO148AN
SVC12QuantityO115R
SVC13Product/Service Id QualifierO22ID
SVC14Product/Service IdO148AN
SVC15Procedure ModifierO22AN
SVC16Procedure ModifierO22AN
SVC17Procedure ModifierO22AN
SVC18Procedure ModifierO22AN
SVC19DescriptionO180AN
SVC20Product/Service IdO148AN
SVC21QuantityO115R
DTP1Date/Time QualifierM33ID
DTP2Date Time Period Format QualifierM23ID
DTP3Date Time PeriodM135AN



© Jobisez LLC - Contact Us  About Us  Privacy Statement  Sitemap  Jobisez Blog