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Specialized Inquiry Screens
HIAR - Health Insurance Action Request
- The Health Insurance System (HIS) is a MEDS-linked database containing private health insurance information on Medi-Cal beneficiaries. The information may be useful in responding to beneficiary inquiries and in identifying insurance carriers. County staff have view-access only to the following options:
- F - Carrier Master File (contains data on insurance providers)
- V - View Insurance Segment (displays detail of health insurance information).
To Obtain
- Choose Option ‘V’Choose Option ‘V’ from the Inquiry Request Menu [MENU] screen, or
- From a blank MEDS screen, type ‘HIAR’ and press Enter.
- From the HIS Action Request Menu, enter Option ‘F’ or ‘V’enter Option ‘F’ or ‘V’.
OPTION F - CARRIER MASTER FILE MENU
Provides users with information on the insurance carrier(s) including name of the carrier, address and carrier code.
To Obtain
- Select Option ‘F’Select Option ‘F’ from the HIS Action Request Menu screen and press Enter.
- Once in the Carrier Master File Menu, select Option ‘V’select Option ‘V’ (View Carrier Record).
- Enter one of the following options and press Enter to access the Carrier Master File Inquiry List screen. The list of Carriers will appear on HICL [CARRIER MASTER FILE INQUIRY LIST] screen in the next page.
- Carrier Name
- Carrier City/Zip Code
- Carrier Code
HICL - Carrier Master File Inquiry Lists
- The Carrier Name option provides an alphabetical listing of all carriers. Type ‘V’Type ‘V’ in the left column to display the View Carrier Record screen.
- The Carrier City/Zip Code option allows the user to access an alphabetical listingaccess an alphabetical listing of carriers based on city address. Type ‘V’ in the left columnType ‘V’ in the left column to display the View Carrier Record screen.
- The Carrier Code option allows the user to obtain an alphabetical listing of carriers by the carrier code enteredthe carrier code entered.
OPTION V - VIEW INSURANCE SEGMENT
Provides users with detailed information of a recipient’s private health insurance. This includes, but is not limited to: policy holder name, policy start and stop date, employer name and address, etc.
To Obtain
- Select Option ‘V’ from the HIS Action Request Menu screen and press Enter.
- Enter the recipient’s MEDS-ID, CIN, COUNTY-ID or HIC-NO in the Client Identification field and press Enter.
The View HIS Information screen appearsView HIS Information screen appears.
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Field Name |
Description |
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SEGMENT TYPE |
Status of a segment when using the View Insurance Segment options: 1 - Active segment 8 - Suspended segment (computer generated) 9 - Suspended segment (suspend entered by DHCS staff) |
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SEGMENT NUMBER |
Number of segment displayed and relationship to all segments; for example 01 of 01 means there is only 1 segment and it is displayed. |
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PLAN-TYPE |
The client’s 3-digit code insurance plan. |
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PLAN-ID |
The client’s 3-digit code level of insurance coverage. |
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TRANS-TYPE |
A - Add; C - Change; L - Letter; V - View. |
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BENE-STATUS |
Benefit status of the client’s insurance. E- Active employee L - Seasonal R - Retiree S - Student |
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RELATIONSHIP TO P.H. |
Relationship of the client to the policyholder D - Dependent of policyholder O - Other P - Policyholder S - Spouse of policyholder |
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POLICY START DATE |
Date that the health insurance policy became effective if known. Otherwise, the system generates date of onset of Medi-Cal eligibility or three years prior to the segment add date, whichever is most recent. |
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STOP DATE |
Date that the health insurance policy stopped, if known. The system will generate a future date, if one is not entered. Currently the system is using December 31, 9999. |
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TERM-REAS |
H - Insurance segment terminated by DHCS/HIS. O - Insurance segment terminated by any other source. |
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SOURCE OF INFO |
Source of information identifying source of other health coverage. BENE - Beneficiary CARRIER - Insurance company CSA - California Children's State Automated System (CCSAS) HIPD - Health Insurance payment demand HIU - Health Insurance Unit IEX - Insurance Data Match MEDS - MEDS MIF/DA - District Attorney MMA - Medicare Modernization Act OCU - Other Coverage Unit PROVIDER - Physician, pharmacy, etc. SSA - Social Security Administration |
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SCOPE OF COVERAGE |
Scope of Coverage identifies type of service available under the policy. Refer to MEDS SCOPE OF COVERAGE for the list of coverage codes. |
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Related Topics
HOLD - MEDS Worker Alerts for Hold Records
HOME - Homeless Assistance Program
IAPP - Application Tracking Inquiry
IEVS - Income and Eligibility Verification System
IN95 - Federal/State MEC Inquiry Request
IN9S - Federal/State MEC Summary Screen
IN9D - Federal/State MEC Detail/Reprint Screen