AAA

Dependent Request Validation

Pos: 160	Max: 9
Detail - Optional
Loop: 2110D	Elements: 3

Ref

Id

Element Name

Req

Type

Min/Max

Usage

AAA01

1073

Yes/No Condition or Response Code
Description: Code indicating a Yes or No condition or response
Industry: Valid Request Indicator

M

ID

1/1

Required

Code

Name

N

No

Use this code to indicate that the request or an element in the request is not valid. The transaction has been rejected as identified by the code in AAA03.

Y

Yes

Use this code to indicate that the request is valid, however the transaction has been rejected as identified by the code in AAA03.

AAA03

901

Reject Reason Code
Description: Code assigned by issuer to identify reason for rejection
Use this code for the reason why the transaction was unable to be processed successfully. This may indicate problems with the system, the application, or the data content.

O

ID

2/2

Required

Code

Name

15

Required application data missing

52

Service Dates Not Within Provider Plan Enrollment

53

Inquired Benefit Inconsistent with Provider Type

54

Inappropriate Product/Service ID Qualifier

55

Inappropriate Product/Service ID

56

Inappropriate Date

57

Invalid/Missing Date(s) of Service

60

Date of Birth Follows Date(s) of Service

61

Date of Death Precedes Date(s) of Service

62

Date of Service Not Within Allowable Inquiry Period

63

Date of Service in Future

69

Inconsistent with Patient's Age

70

Inconsistent with Patient's Gender

AAA04

889

Follow-up Action Code
Description: Code identifying follow-up actions allowed
Use this code to instruct the recipient of the 271 about what action needs to be taken, if any, based on the validity code and the reject reason code (if applicable).

O

ID

1/1

Required

Code

Name

C

Please Correct and Resubmit

N

Resubmission Not Allowed

R

Resubmission Allowed

W

Please Wait 30 Days and Resubmit

X

Please Wait 10 Days and Resubmit

Y

Do Not Resubmit; We Will Hold Your Request and Respond Again Shortly

1.

AAA01 designates whether the request is valid or invalid. Code "Y" indicates that the code is valid; code "N" indicates that the code is invalid.

1.

If AAA02 is used, AAA03 contains a code from an industry code list.

Notes:

1. Use this segment when a request could not be processed at a system or application level and to indicate what action the originator of the request transaction should take.
2. Use this segment to indicate problems in processing the transaction specifically related to specific eligibility/benefit inquiry data contained in the original 270 transaction’s dependent eligibility/benefit inquiry information loop (Loop 2110D).

Example:

AAA*N**70*C~