Review: EQ Types and POS

Summary

Summary

EQ Types: What is it and how is it used?

  • Also known as Service Type code
  • Are used to identify the classification of service or benefits
  • Will be included in the call (API or 270) that is made to you for benefits
  • Does not directly show in the UI

Places of Service (POS): What is it and how is it used?

  • Indicates the setting in which a service is provided
  • Presented in UI in three areas
    • POS available for a clinical service are shown in the More Details section
    • Healthsparq will call your benefits service for each relevant POS to obtain correct benefit for that setting

EQ Types and POS: Template

  • File needs to be tab delimited (.tsv or .txt)
  • File needs to include header (template will be provided)
  • For default EQ Types and POS - refer to Cost Data Domain-Regional-Clients or Cost Data Domain-Blue-Clients
  • Includes 4 fields
    • Service Key - required
      • CPT|2021|10021
    • Places of Service - can be left blank and will use default
      • List should be separated by commas with no spaces
      • 22,19,11,49,24,20,23,21
    • EQ Type - can be left blank and will use default
      • Should contain ONE entry
      • 2
    • Apply - required
      • TRUE or FALSE - Can have entries that you have reviewed but don’t yet want applied set to FALSE
      • TRUE