Why don’t I see an expected value returned in an eligibility response?
Last Updated March 2nd, 2017
All trading partners who transact via EDI are required to support an eligibility request for health benefit plan coverage (service type code 30). As such, if no specific service type is identified on an eligibility submission, PokitDok will default the request to a service type of health benefit plan coverage. If a particular service type is identified on an eligibility request, certain trading partners will respond with plan details specific to that service type. Responses may vary per trading partner based on the service type(s) submitted.