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BENEF Explanation (Sample)
|
SAMPLE BENEFIT PLAN AND BRULES |
|
| BENEFIT PLAN | BRULES ATTACHED |
|---|---|
| 57B00001 STANDARD TX 30 BRULES |
ADMCDDAYS ADMCDOUTP1 ADMCDOUTP2 OHINVALID MHPARHOSPA MHPARHOSPC 570000000560 STD NONMCD EXCLUS-1 5700000007 60 STD NONMCD EXCLUS-3 5700000008 60 STD NONMCD EXCLUS-4 ALL SUBSIDY RULES (21) |
| 57B00002 OUT OF COUNTY PLAN 31 BRULES |
ADMCDDAYS ADMCDOUTP1 ADMCDOUTP2 OHINVALID MHPARHOSPA MHPARHOSPC 5700000005 60 STD NONMCD EXCLUS-1 5700000007 60 STD NONMCD EXCLUS-3 5700000008 60 STD NONMCD EXCLUS-4 5700000013 50 OOC HOLDS #1 ALL SUBSIDY RULES (21) |
| 57B00003 PREVENTION AND ADJ. SRVS PLAN 7 BRULES |
ADMCDDAYS ADMCDOUTP1 ADMCDOUTP2 OHINVALID MHPARHOSPA MHPARHOSPC 5700000012 60 PREV/ADJUNC ONLY |
| 57B00004 MH ONLY 33 BRULES |
ADMCDDAYS ADMCDOUTP1 ADMCDOUTP2 OHINVALID MHPARHOSPA MHPARHOSPC 5700000008 60 STD NONMCD EXCLUS-4 57FY200106 50 STD NONMCD EXCLUS-2 57B2002 60 NEW MEDEF EXCLUSION ALL SUBSIDY RULES(21) |