Eligibility Premium Features

primary coverage indicator if the feature is enabled by a pbm/payer that returns coverage and there are multiple coverages inside a single response envelope containing the eligibility responses, they will be listed in order of priority all coverages will be returned and the requester of the eligibility can select among the coverages the specific fields below are used to determine primary, secondary, and tertiary eligibility coverages surescripts strongly recommends sending these fields to enhance the functionality of the primary coverage indicator loop 2120c nm101 entity id code primary, secondary, tertiary indicator loop 2110c eb04 insurance type code type of insurance loop 2110c eb05 plan coverage description free text values that describe insurance plan loop 2110c ref03 description group name (when ref01 = 6p) note ordering is done to the best of surescripts’ ability when applicable parties are opted into the system regardless of the presence of the recommended fields coverage labeling if the feature is enabled by a pbm/payer that returns coverage which can be identified by its coverage type, the insurance type code (loop 21110c eb04) will be filled out with one of the following values c1 commercial coverage ot medicare part d coverage mc medicaid coverage wc worker's comp coverage note coverage labeling is done to the best of surescripts' ability when applicable parties are opted in to the system regardless of the presence of recommended fields