How can I properly codify a plan with multiple networks and different benefits within each network? For example, a plan with Provider Network A and Provider Network B. Can I use EB05 to identify the network? Should I use a MSG segment?
EB*A**38**PROVIDER NETWORK A***0.2****Y~
EB*A**38**PROVIDER NETWORK B***0.3****Y~
EB*A**38*****0.5****N~
Or
EB*A**38*****0.2****Y~
MSG*PROVIDER NETWORK A~
EB*A**38*****0.3****Y~
MSG*PROVIDER NETWORK B~
EB*A**38*****0.5****N~
Is there a different way to identify the network that is associated with the benefit?
Use of EB05 would not be compliant with the requirements of 005010X279A1 to identify a provider network as this element is only to be used for a Plan Name, not to identify a Provider Network. The note on EB05 states “This element is to be used only to convey the specific product name or special program name for an insurance plan.”