DELTA DENTAL OF MASSACHUSETTS
Client Level Configurations
- ISA06/GS02: Uses client’s Tax ID
- ISA08/GS03: Carrier requires value of DDMA
- GS06: Group Control Number assigned by sender must match GE02 in footer. Cannot start with zero.
- N102: Group Name
- N104: Group Tax ID #
- N102: Carrier Name
- N104: Carrier Tax ID # (provided by carrier)
Loops1000C/1100C-These loops are optional. The carrier will communicate if they require this loop for your client setup.
- REF*1L –This is a required segment. All other REF segments are optional
- INS03-Carrier requires a value of 030
- These loops are situational. The carrier does not use some of the segments and will identify which to include, if any.
- The required DTP dates for this loop are below
- All REF segments in this loop are optional. The carrier will advise if any of the optional segments are needed for your case.
- GE02: Group Control Number must be 1-9 characters long and match GS06 value in the Header. Cannot start with zero.
Note: All segments noted with a (s) are situational, or optional. If the carrier is not specifically advising you to use that field, we recommend you de-select that loop.