United States Health Information Knowledgebase

 

All Payer Claims: Data Element Comparison

Selected Items
Action Name Data Element ID Version State/Organization
Coinsurance Amount PC041 2010-03-16 Maine
Coinsurance Amount PC041 v1.2 Maine
Data Element: Coinsurance Amount PC041 - 2010-03-16
(Maine)
Coinsurance Amount PC041 - v1.2
(Maine)
[Shared]Data Element ID PC041 PC041
[Unshared]Definition Not Provided This amount is paid by the member and reflects the Percentage a member must pay toward the cost of a covered service. In many health insurance plans the coinsurance a member is responsible for is capped after a certain dollar amount of eligible expenses have been incurred. This is a money field containing dollars and cents with an implied decimal point. This field may contain a negative value.
[Shared] State / Source Maine
Maine
[Unshared]Data Type decimal NUMBER
[Shared]Length 10 10
[Shared]Field Name COINS COINS
[Unshared]DATE AVAIL '1/1/2003 Not Supplied
[Unshared]Date Required Not Supplied '2003-01-31
[Unshared]Warnings Not Supplied Not all payers can distinguish between the mutually exclusive fields of copay, coinsurance amount and deductible. To determine the total out of pocket/member responsibility for this service you must sum all three fields. (PC040,PC041, PC042) Payers must verify submissions with less than 25% of the records containing a member payment (coinsurance amount, deductible amount, copay).
Data Element: Coinsurance Amount PC041 - 2010-03-16
(Maine)
Coinsurance Amount PC041 - v1.2
(Maine)
There are no enumerated permissible values for these data elements.
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