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OTI -

Other insurance
UN/CEFACT Revision 2004B Segment List

Function:To provide payer, insured, and payment information when benefits are being coordinated between third party benefit carriers.
This segment also occurs in the following versions of this standard:
D99B, D00A, D00B, D01A, D01B, D01C, D02A, D02B, D03A, D03B, D04A, D04B

Pos Segment M/C Repeat Repr. Notes
010 E206 OBJECT IDENTIFICATION M 5
7402 Object identifier M an..35
7405 Object identification code qualifier C an..3
4405 Status description code C an..3
020 9645 Payer responsibility level code M 1 an..3
030 E507 DATE/TIME/PERIOD C 2
2005 Date or time or period function code qualifier M an..3
2380 Date or time or period text C an..35
2379 Date or time or period format code C an..3
040 5267 Service type code C 10 an..3
050 5004 Monetary amount C 4 n..35
060 E030 ADJUSTMENT INFORMATION C 15
9619 Adjustment category code M an..3
4465 Adjustment reason description code M an..3
5004 Monetary amount C n..35
070 4497 Insurance cover type code C 1 an..3
080 9143 Relationship description code C 1 an..3
090 9607 Yes or no indicator code C 1 an..3

PosPosition
M/CMandatory or Conditional
Repr.Representation (Data or Content Type)

Segment OTI is used in the following messages:
IHCLME

Change indicators
plus sign An addition.
asterisk Addition/substraction/change to a code entry for a particular data element.
hash or pound sign Changes to names.
vertical bar Changes to text for descriptions, notes and functions.
minus sign A deletion.
letter X Marked for deletion.

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