Name of School Not Going EDI; Student Flag
Summary:
If a customer reports a problem with EDI claims with the School name not being transmitted during electronic submission to insurer, there may be a problem with the setup of the insurance details for the patient.
More Information:
The Student flag is only used to identify if a patient attending post-secondary education (ie college or university) and that patient is covered under the parent's insurance plan while in post-secondary education and is under a certain age (usually age 25 and under, but may vary based on specific insurance plan). If checking the Student flag, the School name must be entered in the School field and this information will be included in the EDI claim.
The Student box should only be checked
- If the patient is covered under the parent's insurance coverage (for mature students age 18-25 unless coverage specifies otherwise), and
- The Relationship to Subscriber is set to Child
For children age 0-18, do NOT check the Student flag, since it is understood that they are covered under the parent's insurance. It is NOT necessary to fill in the school name for these patients.
If the Relationship to Subscriber is set to Self, do not check the Student box ever.
References
Product (s): ABELDent
Category: Insurance
Classification: Private, Public
Date Created: 28MAR14
Created by: RosemaryL