EDI
API DocsTerminal

OI Other Health Insurance Information

To specify information associated with other health insurance coverage

Sequence
Element
Name
Type
Requirement
Min
Max
Repeat
01
1032
Claim Filing Indicator Code
Identifier (ID)
Optional
1
2
1
Code identifying type of claim
Codes (52)
02
Claim Submission Reason Code
Identifier (ID)
Optional
2
2
1
Code identifying reason for claim submission
Codes (21)
03
Yes/No Condition or Response Code
Identifier (ID)
Optional
1
1
1
Code indicating a Yes or No condition or response
OI03 is the assignment of benefits indicator. A "Y" value indicates insured or authorized person authorizes benefits to be assigned to the provider; an "N" value indicates benefits have not been assigned to the provider.
Codes (9)
04
Patient Signature Source Code
Identifier (ID)
Optional
1
1
1
Code indicating how the patient or subscriber authorization signatures were obtained and how they are being retained by the provider
Codes (5)
05
Provider Agreement Code
Identifier (ID)
Optional
1
1
1
Code indicating the type of agreement under which the provider is submitting this claim
Codes (7)
06
Release of Information Code
Identifier (ID)
Optional
1
1
1
Code indicating whether the provider has on file a signed statement by the patient authorizing the release of medical data to other organizations
Codes (6)
07
Provider Accept Assignment Code
Identifier (ID)
Optional
1
1
1
Code indicating whether the provider accepts assignment
Codes (4)
08
Yes/No Condition or Response Code
Identifier (ID)
Optional
1
1
1
Code indicating a Yes or No condition or response
OI08 is payer-to-payer adjustment code. A "Y" value indicates a payer-to-payer COB claim is an adjustment. An "N" value indicates payer-to-payer COB claim is not an adjustment.
Codes (9)
09
Yes/No Condition or Response Code
Identifier (ID)
Optional
1
1
1
Code indicating a Yes or No condition or response
OI09 is payer to data reporting adjustment code. A "Y" value indicates a payer-to-data reporting entity claim is an adjustment. An "N" value indicates payer-to-data reporting entity claim is not an adjustment.
Codes (9)
10
Yes/No Condition or Response Code
Identifier (ID)
Optional
1
1
1
Code indicating a Yes or No condition or response
OI10 is payer-to-payer void code. A "Y" value indicates a payer-to-payer COB claim is a void. An "N" value indicates payer-to-payer COB claim is not a void.
Codes (9)
11
Yes/No Condition or Response Code
Identifier (ID)
Optional
1
1
1
Code indicating a Yes or No condition or response
OI11 is payer to data reporting void code. A "Y" value indicates a payer-to-data reporting entity claim is a void. An "N" value indicates payer-to-data reporting entity claim is not a void.
Codes (9)

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Stedi is a registered trademark of Stedi, Inc. Stedi's EDI Reference and Mapping Guides are provided for marketing purposes and are free of charge. All names, logos, and brands of third parties listed on our site are trademarks of their respective owners (including “X12”, which is a trademark of X12 Incorporated). Stedi, Inc. and its products and services are not endorsed by, sponsored by, or affiliated with these third parties. Our use of these names, logos, and brands is for identification purposes only, and does not imply any such endorsement, sponsorship, or affiliation.