HIPAA 5010 Platform
*Please note that a copy of Dental Select's Companion Guide has not been attached to this documentation. Dental Select provides an excel document that is specific to each client; it is a combination Companion Guide & Group/Account Structure.
Client Level Configurations
- ISA06: Interchange Sender ID-Use sender's identification, usually the TAX ID
- GS02: Senders Tax ID
- GS06: Group Control Number Assigned by Sender must match GE02 in footer (required to be 1-9 digits)
- REF*38 is situational. Refer to group structure to see if required for your setup
- N102: Plan Sponsor Name
- N104: Plan Sponsor Tax ID
- N102: TPA or Broker Name
- N104: TPA or Broker Tax ID
- This loop is optional
- Exclude all REF segments except REF OF and REF 1L unless specifically asked to include by carrier
- HD03-Insurance Line Code will be DEN for dental coverage and VIS for Vision coverage. This carrier also has additional benefits not currently supported by Employee Navigator’s export engine
- HD04-Plan Coverage Description: This is required for this carrier and is referenced by the carrier as PLAT 1
- REF segments-Carrier requires REF*1L in this loop. Optional REF segments for this loop and carrier is REF*ZZ and REF*17. The carrier will notify you if any optional loops are needed.
Loop 2310 and 2320
- Exclude from client level configuration unless carrier specifically asks to include.
- GE02: Group Control Number Assigned by Sender must be the same as GS06
Carrier Operational Notes:
- Terms are set to drop off file after 14 days
- COBRA terminations drop of file after 60 days
Last updated 3/22/2016