Benefits Coordination (R.304)

overview this section holds the application certification requirements located in the benefits coordination elements docid\ cg2at60ni9vyh8pc9tq1v section in the guide r 304 r 304 prescribing vendors who are utilizing the surescripts eligibility 270/271 messages shall populate the first benefitscoordination element with the associated information returned in a surescripts 271 message if more than one active coverage is returned, only the single coverage information utilized to write the prescription is sent subsequent benefitscoordination elements should be used for coupon/discount information prescribing vendors who are not utilizing the surescripts eligibility 270/271 messages should use the first benefitscoordination element for coupon/discount information the 271 message’s isa13 control number shall be populated in the benefitscoordination/interchangecontrolnumber field in all instances including scenarios where there’s no active coverage identifier 271 x12 data type benefits coordination script 2023011 schema interchange control number isa 13 n 9/9 interchange controlnumber n 9 pbm participant id 2100a/nm1/09 an 2/80 payer identification/ payerid an 1 80 pcn 2110c1/ref/03 when ref/01 = “n6” an 1/80 payer identification/ processor identification number an 1 35 pbm/payer name 2100a/nm1/03 an 1/60 payername an 1 70 pbm member id 2100c/nm1/09 an 2/80 pbmmemberid an 1 80 cardholder id 2100c/ref/01 when ref/01 = "hj" an 1/50 cardholderid an 1 35 bin 2110c1/ref/02 when ref/01 = “n6” an 1/50 payer identification/ iinnumber an 1 35 group number 2110c1/ref/02 when ref/01 = “6p” an 1/50 groupid an 1 35 group name 2100c1/ref/03 when ref01 = "6p" an 1/80 groupname an 1 70 note there are differences between the field lengths in the eligibility and script schemas that could result in data being truncated