Companion Guide

Benefit Enrollment and Maintenance

American Specialty Health submitter/receiver ID: 36-2805852

ASH Requirements for this transaction:

All required segments/elements as identified in the transaction.

Additional Situational segments/elements that are required: (If the situational segment is present all required elements within the segment must be populated)

Loop 2000 – Member Level Detail

• Member Policy Number
• Reference Identification – REF Qualifier – 1L
• Member Identification Number
• Reference Identification – REF – Qualifier – 23L
  (Can be repeated 5 times if additional information is determined to be necessary by the submitter).

Loop 2300 – Health Coverage

• Health Coverage – HD – (Maintenance Type Code)
• (Required when enrolling a new member or adding, updating, or removing coverage from an existing member.
• Health Coverage Policy
  • Reference Identification – AMT – Monetary Amount

Contact: Robert Ryan at robertr@ashn.com