How to identify Medicare Advantage insurance plan in 271
Are there solid criteria to identify Medicare Advantage insurance plan type by looking at 271 responses from a commercial payer?
@0kutsenk We are not 100% positive on this, but looking at the following resource, https://www.cms.gov/research-statistics-data-and-systems/cms-information-technolog[…]library/243611272/r2023q200-hets-270/271-companion-guide-v10-32, we see that EB01 and EB04 might be what you are looking for in terms of Medicare Advantage.
Let us know if this helps!
@dkanter Thank you. It makes sense, but only for 271 from Medicare. Indeed HETS returns a 271 2110C EB01 of ‘U’ for
Medicare Advantage plans (as the companion guide states). But unfortunately, commercial payers don't do this in their 271s. So, I was hoping to find an indication of Medicare Advantage in the 271 response from the commercial payer.