979 - Insurance Descriptor Codes

Maintenance Request Status 5/17/2018 LAST UPDATED

These codes describe, identify, or clarify the insurance being reported in an eligibility and benefits response.

The list below shows the status of change requests which are in process. Generally, the list is updated on the first of each month.

Each request will be in one of the following statuses:

  1. Received
    The request has been submitted but is not yet under review.
  2. Triaged
    Staff has looked at the request to ensure it's a legitimate request (not spam), that it is assigned to the correct CMG, and that all required information is present.
  3. In Process
    The CMG has initiated their decision process.
  4. On Hold
    The CMG has initiated their decision process but cannot complete it at this time.
  5. CMG Approved
    The CMG has considered and approved the request, this does not mean it was approved exactly as submitted, it means maintenance related to the request was approved. Requests in this status will be applied to the next version.
  6. CMG Disapproved
    The CMG has considered and disapproved the request, no maintenance action will occur. Requests in this status are complete/final.
Num. Date Requested Description Type Code Status
6 7/1/2017 Medicare - Point of Service (POS) New code Disapproved
8 7/1/2017 Multiple Options Health Plan New code Disapproved
9 7/1/2017 Medicare Secondary Working Aged Beneficiary or Spouse with Employer Group Health Plan New code Triaged
10 7/1/2017 Medicare Secondary End-Stage Renal Disease Beneficiary in the Mandated Coordination Period with an Employer's Group Health Plan New code Triaged
11 7/1/2017 Medicare Secondary, No-fault Insurance including Auto is Primary New code Triaged
12 7/1/2017 Medicare Secondary Worker's Compensation New code Triaged
13 7/1/2017 Medicare Secondary Public Health Service (PHS)or Other Federal Agency New code Triaged
17 7/1/2017 Medicare Secondary Black Lung New code Triaged
18 7/1/2017 Medicare Secondary Veteran's Administration New code Triaged
19 7/1/2017 Medicare Secondary Disabled Beneficiary Under Age 65 with Large Group Health Plan (LGHP) New code Triaged
20 7/1/2017 Medicare Secondary, Other Liability Insurance is Primary New code Triaged
23 7/1/2017 Consolidated Omnibus Budget Reconciliation Act (COBRA) New code Triaged
24 7/1/2017 Medicare Conditionally Primary New code Disapproved
25 7/1/2017 Disability Benefits New code Disapproved
27 7/1/2017 Family or Friends New code Disapproved
28 7/1/2017 Group Policy New code Disapproved
33 7/1/2017 Health Maintenance Organization (HMO) - Medicare Risk New code Disapproved
37 7/1/2017 Individual Policy New code Disapproved
39 7/1/2017 Long Term Policy New code Disapproved
41 7/1/2017 Litigation New code Triaged
44 7/1/2017 Medicaid New code Disapproved
47 7/1/2017 Medicare Advantage Private Fee for Service New code Disapproved
48 7/1/2017 Medigap Part A New code Disapproved
49 7/1/2017 Medigap Part B New code Disapproved
56 7/1/2017 Medicare Primary New code Disapproved
59 7/1/2017 Medicare Advantage New code Disapproved
61 7/1/2017 Other New code Disapproved
63 7/1/2017 Personal New code Disapproved
64 7/1/2017 Personal Payment (Cash - No Insurance) New code Disapproved
67 7/1/2017 Qualified Medicare Beneficiary New code Disapproved
70 7/1/2017 Tax Equity Fiscal Responsibility Act (TEFRA) New code Disapproved