Data Clarifications for the 834 Transaction Set Delta Dental would prefer to receive the basic character set Preferred Values for Elements Page # Id Reference Name Codes Length Notes/Comments 48 2000 INS01 Yes/No Condition Response Y Subscriber 1/1 – Code Insured Indicator N - Dependent – 48 2000 INS02 Individual Relationship Code The preferred values for this are: 2/2 01 Spouse – 09 Adopted Child – 10 Foster Child – 15 Ward – 17 Stepson or Stepdaughter – 18 Self (Subscriber) – 19 Child – 23 Sponsored Dependent – 25 Ex-Spouse – 53 Life Partner – 49 2000 INS03 Maintenance Type Code 001 Change 3/3 – 021 Addition – 024 Cancellation or – termination 025 Reinstatement – 030 Audit or Compare – 49 2000 INS05 Benefit Status Code The preferred values for this are: 1/1 A Active – C COBRA –
Data Clarifications for the 834 Transaction Set Delta Dental would prefer to receive the basic character set Preferred Values for Elements Page # Id Reference Name Codes Length Notes/Comments 48 2000 INS01 Yes/No Condition Response Code – Insured Indicator Y – Subscriber N - Dependent 1/1 48 2000 INS02 Individual Relationship Code The preferred values for this are: 01 – Spouse 09 – Adopted Child 10 – Foster Child 15 – Ward 17 – Stepson or Stepdaughter 18 – Self (Subscriber) 19 – Child 23 – Sponsored Dependent 25 – Ex-Spouse 53 – Life Partner 2/2 49 2000 INS03 Maintenance Type Code 001 – Change 021 – Addition 024 – Cancellation or termination 025 – Reinstatement 030 – Audit or Compare 3/3 49 2000 INS05 Benefit Status Code The preferred values for this are: A – Active C – COBRA 1/1