Files > EFFECTIVE DATE

parent

355.1

name

EFFECTIVE DATE

number

355.14

Fields

#	Name	Location	Type	Details	Index	Description
.01	effective date	0;1	DATE-TIME		B	This is the date on which the coverage amounts paid by a supplemental Type of Plan go into effect. The percentages paid are stored by Date, Group Code and Reason Code. When these percentages change, a new effective date should be entered along with each Group and Reason Code for which this plan pays. If there is no effective date entry or the effective date is AFTER the claim service From date, the secondary balance due will be calculated as 100% of Patient Responsibility as indicated on the Medicare-equivalent Remittance Advice (MRA).
1	group code	1;0	MULTIPLE	355.141		These are the group code(s) for which this type of plan pays all or a percentage of the adjustments made to the original claim by the payer during adjudication. For example, if there is an entry for Group Code CO, this plan pays all or part of Excess Charges.