Class steward is Patient Administration
A level of coverage for a selected class of Healthcare services.
Description of the access protocol for the benefit service type.
An indication that the benefit service is a capitated service.
An indication that coinsurance is applicable for the benefit service.
The coinsurance percentage for the benefit service.
The copayment amount for the benefit service.
The benefit service deductible amount.
The lower coverage limit.
The payment limit on the benefit service.
An indicator that the benefit service provided by a non primary provider must have a referral from a primary care provider to be covered.
An indicator that the benefit service must be provided by a primary care provider to be covered.
A indication that the benefit service will be subject to review prior to payment.
|IN3^20^00521^Pre-Certification Req/Window|
The upper limit of the benefit coverage.