You use the Eligibility Confirmation page to view eligibility details about the confirmation received by the provider when he/she did a eligibility check on the member.
The Eligibility Confirmation page contains fields in the following panels:
| Field | Description |
|---|---|
| Confirmation ID | The confirmation ID provided to the provider at the time they checked on the eligibility of a member's benefits. |
| Source of Inquiry | The source that requested the inquiry for eligibility. |
| Member ID |
Unique identifier used for a member and is assigned when the member becomes eligible to receive Medicaid benefits. |
| Member ID Type |
Unique code indicating the type of member identification. Examples: Member ID, Medicaid ID, Medicare ID, SSN |
| Member Name |
The name of person associated with the member ID. |
| Member DOB |
The date the person was born; the person's date of birth. Format: MM/DD/YYYY Example: 05/23/1935 |
| Member SSN |
Social Security Number. A nine-digit number assigned by the Federal government, usually assigned at the time of birth and used for tax purposes. Format: NNN-NN-NNNN or NNNNNNNNN Example: 123-45-6789 |
| Provider ID |
Unique identifier used for a provider of healthcare services. Format: Up to 15 alphanumeric characters |
| Provider ID Type |
Unique code that indicates the type of provider ID entered. Examples: DEA, NPI, SSN/EIN |
| Provider Name | The name of the provider. |
| Field | Description |
|---|---|
| Eligibility Type | The type of eligibility associated with the guarantee. |
| Guarantee Begin Date | The beginning date of the guarantee's eligibility. |
| Guarantee End Date | The ending date of the guarantee's eligibility. |
| Field | Description |
|---|---|
| Category of Eligibility |
The guarantee's type of eligibility coverage under Medicaid. Example: BCCP - Breast/Cervical Cancer Program |
| LOB |
The unique code that identifies the line of business, a high-level payer, or funding source such as Medicaid. |
| Benefit Plan ID |
Unique identifier for the benefit plan. |
| COE/BP Guarantee Begin Date | The beginning date for the guarantee's category of eligibility for the specified benefit plan. |
| COE/BP Guarantee End Date | The date that the guarantee's category of eligibility for the specified benefit plan is no longer valid. |
Version as of 5/16/14.
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