OI Other Health Insurance Information
To specify information associated with other health insurance coverage
Position
Element
Name
Type
Requirement
Min
Max
Repeat
Code identifying type of claim
Code identifying reason for claim submission
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.
Code indicating how the patient or subscriber authorization signatures were obtained and how they are being retained by the provider
Code indicating the type of agreement under which the provider is submitting this claim
Code indicating whether the provider has on file a signed statement by the patient authorizing the release of medical data to other organizations
Code indicating whether the provider accepts assignment