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Segment
in
X12 Release 003040

BCI Basic Claim Information

To identify information basic to the processing of any claims transaction
Sequence
Element
Name
Type
Requirement
Min
Max
Repeat
01
1271
Industry Code
String (AN)
Optional
1
20
-
Code indicating a code from a specific industry code list
BCI01 is used to specify the line of insurance (i.e., line of business).
02
Insurance Type Code
Identifier (ID)
Optional
1
3
-
Code identifying the type of insurance policy within a specific insurance program
Codes (30)
03
Reference Number
String (AN)
Optional
1
30
-
Reference number or identification number as defined for a particular Transaction Set, or as specified by the Reference Number Qualifier.
BCI03 is used to specify the actual policy number.
04
State or Province Code
Identifier (ID)
Optional
2
2
-
Code (Standard State/Province) as defined by appropriate government agency.
BCI04 is used to specify the state associated with the policy (i.e., policy's base state).
05
Date Time Period Format Qualifier
Identifier (ID)
Conditional
2
3
-
Code indicating the date format, time format, or date and time format.
P0506
Codes (22)
06
Date Time Period
String (AN)
Conditional
1
35
-
Expression of a date, a time, or range of dates, times or dates and times.
BCI06 is used to specify the range of dates the policy was in effect.
07
Report Type Code
Identifier (ID)
Optional
2
2
-
Code indicating the title or contents of a document, report or supporting item
Codes (258)
08
Currency Code
Identifier (ID)
Optional
3
3
-
Code (Standard ISO) for country in whose currency the charges are specified.
BCI08 is used to specify the currency specified in a contractual agreement of the policy.
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Stedi is a registered trademark of Stedi, Inc. Stedi's EDI Reference and Mapping Guides are provided for marketing purposes and are free of charge. All names, logos, and brands of third parties listed on our site are trademarks of their respective owners (including “X12”, which is a trademark of X12 Incorporated). Stedi, Inc. and its products and services are not endorsed by, sponsored by, or affiliated with these third parties. Our use of these names, logos, and brands is for identification purposes only, and does not imply any such endorsement, sponsorship, or affiliation.