Limitations of the ASCII Flat File

Not all the information that can be contained in the 834 transaction set is written to the file. The following limitations apply.

·Loop 2300: "Health Coverage"; only three different coverages are listed. The standard allows 99. The IDC segment, "Identification Card," is disregarded.

·Loop 2310: "Provider Information"; only 1 provider per health coverage is displayed. 30 are allowed in the 834.

·Loop 2320: "Coordination of Benefits"; only one COB payer is listed. 5 are allowed under the standard.

HIPAAsuite believes that we display the most common elements that fit on a single page. If you need additional information, please contact us so that we can make necessary changes.

Below is a list of the exported fields.

Header Information

·Subscriber Yes/No

·Relationship

·Maintenance Type

·Maintenance Reason

·Benefit Status

·Medicare Plan Code

·Employment Status

·Student Status

·Subscriber Number

·Group Number

Additional Identifiers

·ID Type 1"

·ID 1"

·ID Type 2"

·ID 2"

·ID Type 3"

·ID 3"

·Dates

·Date Type 1"

·Date 1"

·Date Type 2"

·Date 2"

·Date Type 3"

·Date 3"

Member Info

·Member Last Name

·Member First Name

·Member Middle Name

·Member NM1_09

·First Comm Number

·Second Comm Number

·Address 1

·Address 2

·City

·State

·Zip

·Birthdate

·Gender

·Marital Status

Incorrect Information

·Incorrect Last Name

·Incorrect First Name

·Incorrect ID

Mailing Address

·Mailing Address 1

·Mailing Address 2

·Mailing City

·Mailing State

·Mailing Zip

Custodian

·Custodian Last Name

·Custodian First Name

·Custodian Middle Name

·Custodian ID

·Address 1

·Address 2

·City

·State

·Zip

Disability

·Disability Type"

·Disability Begin"

·Disability End"

Coverage

Note: Three Benefits maximum in ASCII file.

·Maintenance Type

·Insurance Type

·Description

·Coverage Level

·Effective Date

·Benefit Begin

·Benefit End

·Policy Number

·Provider Type

·Provider Last Name

·Provider First Name

·Provider Middle Name

·Provider ID

·Relationship

·Provider City

·Provider State

·PCP Action Code

·Effective Date

·PCP Change Reason

·COB Sequence

·Group Number

·First Ref Value

·COB From

·COB To