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Healhcare Information Technology Standards Panel
HealthCare Information Technology Standards Panel
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HITSP’s four primary membership categories include standards development organizations (SDOs); non-SDO stakeholder organizations; governmental bodies and consumers.


Capability

CAP 140 - Communicate Benefits and Eligibility

This Capability addresses interoperability requirements that support electronic inquiry and response about a patient’s eligibility for health insurance benefits. The information exchanged includes the following: • A patient’s identification (e.g., name, date of birth, and the health plan’s member identification number) • Communication of a member’s status of coverage and benefit information and financial liability • Access to information about types of services, benefits and coverage for various medical care and medications This Capability provides clinicians and healthcare providers with information about their patient’s health insurance coverage and benefits.

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ConstructTitle / VersionReferenced byStatusDocument Access
CAP 140Communicate Benefits and Eligibility
Version:1.0
IS 9 V:1.0.2
IS 7 V:1.1.1
IS 91 V:0.0.1
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(Panel Approved)
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