Claim Response Coverage Type
Usage: ClaimResponse.subType
Conformance Rule: This will be used to convey the "type" of Claim/Claim Response in accordance with the Plan Type. Set value = "public" or "private" or "unknown".
Rationale: This value will be conveyed in downstream claim requests (eg secondary, tertiary), as part of the Prior Claim Response to assist in proper coordination of benefits. This will be mapped from prior claim responses
Code | Description | CPHA Field Length |
---|---|---|
public | The plan type is public | |
private | The plan type is private | |
patientAssistedCard | The plan uses a patient Assisted Card | |
unknown | The plan type is unknown, eg mapping from CPHA |