: Used if the inquiry is for a family member under the subscriber's policy.
: Contains the primary policy holder's information (Name, Member ID, DOB).
The EDI 270 schema establishes the data content for inquiring about eligibility and benefits associated with a plan. It follows the standard. Structure & Loops : ST/SE : Transaction set header and trailer.
: Eligibility inquiry segments, such as service type codes (e.g., "30" for general medical). Operational Modes :
: Identifies the payer (e.g., insurance company).