Enum X12PlanParticipationCode
Code assignment of the relationship between the provider and the payer and NOT whether the patient has or has not assigned benefits to the provider.
Namespace: Bishop.X12
Assembly: Bishop.X12.dll
Syntax
public enum X12PlanParticipationCodeFields
| value | Name | Description |
|---|---|---|
| 2 | Assigned | Required when the provider accepts assignment and/or has a participation agreement with the destination payer. OR Required when the provider does not accept assignment and/or have a participation agreement, but is advising the payer to adjudicate this specific claim under participating provider benefits as allowed under certain plans. |
| 3 | AcceptedClinicalLabOnly | Required when the provider accepts assignment for Clinical Lab Services only. |
| 4 | NotAssigned | Required when neither codes ‘A’ nor ‘B’ apply. |