KY MMIS 834 Companion Guide - Kymmis.com

Commonwealth of Kentucky – MMISKY MMIS 834 Companion Guide834 Benefit Enrollment and Maintenance144 2300 DTP DTP03 – Coverage Period Use to denote the begin andend dates for the various typesof coverage sent in the HD04– For HD04 PRG Loop 2300Records, Qualifier 348:This is the expected deliverymonth with a defaulted day.Please note: Pregnant womenare exempted from co-pay forprenatal, delivery, andpostpartum services (postpartum is 60 days fromdelivery) The eligibilitysystem (KAMES) will flag amember exempt from co-payfor the month of delivery andthe two calendar monthsfollowing delivery. Example-If a baby is delivered in June,the mother continues to beexempted until the last day ofAugust. The co-pay indicatoris passed in the HD04 ELGsegment (HD04-10).There will not be a seconditeration of the DTP segmentfor this type of Loop 2300.145 2300 AMT AMT01 - Amount Qualifier Code ‘D2’ – Deductible Amount tobe used for Patient Liability.This data element will only besent for HSP records in HD04145 2300 AMT AMT02 – Contract Amount This data element will only besent for HSP records in HD04152 2310 LX LX01 – Assigned Number ‘1’ – One PreferredProvider will be sent153 2310 NM1 NM101 - Entity Identifier Code ‘Y2’ – Managed CareOrganizationDMS Approved 12/02/2011 Page 20