BGN

Beginning Segment

Pos: 020	Max: 1
Heading - Mandatory
Loop: N/A	Elements: 7

Ref

Id

Element Name

Req

Type

Min/Max

Usage

BGN01

353

Transaction Set Purpose Code
Description: Code identifying purpose of transaction set
If the original transaction has already been processed, an incoming transaction using this code may be rejected by the receiver. The rejection will be identified to the sender by telephone or other direct contact.

M

ID

2/2

Required

Code

Name

00

Original

The ‘‘00’’ indicates the first time the transaction is sent.

15

Re-Submission

Send the ‘‘15’’ when the original transmission was incorrect, has yet to be processed by the receiver, and a new corrected transmission is being sent. This transmission can then be pended by the receiver’s translator for further review.

22

Information Copy

Send the ‘‘22’’ when the original transmission was lost or not processed, and the sender is passing another transmission that is the same as the original.

BGN02

127

Reference Identification
Description: Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
Industry: Transaction Set Identifier Code
Use the transaction set reference number assigned by the sender’s application to uniquely identify this occurrence of the transaction for future reference.

M

AN

1/30

Required

BGN03

373

Date
Description: Date expressed as CCYYMMDD
Industry: Transaction Set Creation Date
Use this date to identify the date that the submitter created the file.

M

DT

8/8

Required

BGN04

337

Time
Description: Time expressed in 24-hour clock time as follows: HHMM, or HHMMSS, or HHMMSSD, or HHMMSSDD, where H = hours (00-23), M = minutes (00-59), S = integer seconds (00-59) and DD = decimal seconds; decimal seconds are expressed as follows: D = tenths (0-9) and DD = hundredths (00-99)
Industry: Transaction Set Creation Time
Use the time to identify the time of day that the submitter created the file. This element is used as a time stamp to uniquely identify the transmission.

C

TM

4/8

Required

BGN05

623

Time Code
Description: Code identifying the time. In accordance with International Standards Organization standard 8601, time can be specified by a + or - and an indication in hours in relation to Universal Time Coordinate (UTC) time; since + is a restricted character, + and - are substituted by P and M in the codes that follow
Industry: Time Zone Code
CODE SOURCE: 94: International Organization for Standardization (Date and Time)
Use the time code if the sender and receiver are not in the same time zone.
All valid standard codes are used.

O

ID

2/2

Situational

BGN06

127

Reference Identification
Description: Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
Industry: Transaction Set Identifier Code
If BGN01 equals 15 or 22, then BGN06 should be used to cross reference to the previously sent transaction.

O

AN

1/30

Situational

BGN08

306

Action Code
Description: Code indicating type of action

O

ID

1/2

Required

Code

Name

2

Change (Update)

Used to identify a transaction of additions, terminations and changes to the current enrollment.

4

Verify

Used to identify a full enrollment transaction to verify that the sponsor’s and payer’s systems are synchronized.

1.

C0504 - If BGN05 is present, then all of BGN04 are required

1.

BGN02 is the transaction set reference number.

2.

BGN03 is the transaction set date.

3.

BGN04 is the transaction set time.

4.

BGN05 is the transaction set time qualifier.

5.

BGN06 is the transaction set reference number of a previously sent transaction affected by the current transaction.

Example:

BGN*00*11227*19970920*1200*ES***2~