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, Special Programs eg LOE, Patient Support Programs. Typically the payor of last resort

Note: A value of unknown was discussed; however we have deprecated the use of DA and DB. As such a value must be set.