Limitations of the ASCII Flat File

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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 Reasaon
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