|
Position |
Description |
Comments |
|
1 - 3 |
EOB |
Will display an EOB number. |
|
4 |
(Space) |
Format as a constant space. |
|
5 - 10 |
REV SD |
Format as a constant. |
|
11 |
(Space) |
Format as a constant space. |
|
12 - 17 |
Reversed spenddown $ amount |
Will display the amount added back
to the patient's spenddown. Format: 9999v99
Note: This field will only be populated for SeniorCare claims. |
|
18 |
(Space) |
Format as a constant space. |
|
19 - 25 |
REV DED |
Format as a constant. |
|
26 |
(Space) |
Format as a constant space. |
|
27 - 31 |
Reversed deductible $ amount |
Will display the amount added back
to the patient's deductible.
Format: 999v99
Note: This field will only be populated for SeniorCare claims. |
|
32 |
(Space) |
Format as a constant space. |
|
33 - 44 |
REMAINING SD |
Format as a constant. |
|
45 |
(Space) |
Format as a constant space. |
|
46 - 51 |
Remaining Spenddown $ Amount |
Will display the amount the
participant has left to pay before his/her spenddown has
been satisfied. Format: 9999v99
If more than $9,999.99 of spenddown remains, the
field will be filled with dollar signs.
Note: This field will only be populated on SeniorCare claims. |
|
52 |
(Space) |
Format as a constant space. |
|
53 - 65 |
REMAINING DED |
Format as a constant. |
|
66 |
(Space) |
Format as a constant space. |
|
67 - 71 |
Remaining deductible $ amount |
Will display the amount the
participant has left to pay before his/her deductible
has been satisfied. Format: 999v99
Note: This field will only be populated on SeniorCare claims. |
