HIPAA 834, 5010 Platform
EBA&M 5010 Platform
Client Level Configurations
- ISA06/GS02: Interchange Sender ID-Usually the client Tax ID. Carrier will indicate what they prefer
- GS06:Group Control Number-Assigned by Sender must match GE02 in footer (required to be 1-9 digits)
- REF: (Transaction Set Policy Number) –Optional segment. Carrier will provide expected values if it is required for your setup
- N102: Plan Sponsor Name-Usually Client name
- N104: Plan Sponsor Tax ID- Usually Client Tax ID
- These loops are optional. They can be excluded unless the carrier specifically asks to include them in the file.
- Most REF segments in this loop are optional. Below are the required REF segments for this carrier
REF*1L: Group/Policy Number-The carrier will provide the expected values.
REF*DX: Department/Agency Number-The carrier will provide the expected values.
REF*ZZ: Mutually Defined-The carrier will provide the expected values.
REF*17: Member Identification Number-The carrier will provide the expected values.
These loops are optional and the carrier will indicate if they want them included or excluded in your configuration
- Most REF segments in this loop are optional. The carrier will indicate if they require any to be included or excluded
HD04: Plan Coverage Description- Carrier requires a plan number here and will provide it
Loop 2310 and 2320
- These loops are optional and used only if the carrier requires them
- GE02: Group Control Number Assigned by Sender must be the same as GS06
The carrier has not provided their Open Enrollment requirements. Once that is provided this document will be updated. Please refer to the carrier if you have questions regarding their open enrollment/EDI process
- EBA&M expects a unique BGN02 code for each feed. The code will auto generate each time a file is created.
- No PGP encryption key was provided. Carrier uses a SFTP protocol for transmission (Secure)
- Terminated records are set to drop from this carrier’s file feeds at 7 days past the termination date