ME040 Value suffix definitions - Aetna

0113

60054A

Jun 7, 2022

Jun 14, 2022

Included in June 2022 Data Tips email.

The Aetna entity 60054A utilizes a trailing character in the value for Product identifier (ME040) to represent which type of plan benefit the Eligibility line is reporting:

B = Behavioral Health

D = Dental

M = Medical

P = Pharmacy

V = Vision (note, the Arkansas APCD does not include vision insurance claims)

X = Default for benefits we weren’t able to map initially (older files, no longer used)

For example:

ME040 = ‘0010000 DM’ represents a plan with medical coverage.

Active

Product Identifier

Member

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