XML Request

InstaMed Connect supports two methods to process XML real-time Eligibility transactions:

• DoEligibilityInquiry: Returns the eligibility response supplied by the payer
• DoEligibilityInquiryEnhanced: Returns the payer’s eligibility response with the Effective Benefit information determined by InstaMed

The request format is identical for both the DoEligibilityInquiry and DoEligibilityInquiryEnhanced methods.

Field	Format	Required?	Min	Max	Comments
PayerIDQualifier	AN	N	1	2	NOT USED
RecipientID	AN	Y	1	7	Note: InstaMed Payer IDs are available in InstaMed Online in the Configure > EDI Enrollment > Payer List Search screen.
RecipientIDQualifier	AN	Y	1	2
RecipientName	AN	Y	1	35
SubscriberID	AN	N	1	30
SubscriberIDQualifier	AN	N	2	3
SubscriberID2	AN	N	1	30
SubscriberIDQualifier2	AN	N	2	3
SubscriberID3	AN	N	1	30
SubscriberIDQualifier3	AN	N	2	3
SubscriberLastName	AN	N	1	35
SubscriberFirstName	AN	N	1	25
SubscriberMiddleName	AN	N	1	25
SubscriberDateOfBirth	DT	N	1	35	(MM/DD/YYYY)
AsOfDate	DT	N			Default value is Current Date. (MM/DD/YYYY)
PatientLastName	AN	N	1	35
PatientFirstName	AN	N	1	25
PatientMiddleName	AN	N	1	25
PatientDateOfBirth	DT	N	1	10	(MM/DD/YYYY)
PatientRelationship	AN	Y	2	2
PatientGender	AN	N	1	1
TraceNumber	AN	N	1	30
ServiceTypeCode	AN	N	1	2
ProviderLastName	AN	N	1	35
ProviderFirstName	AN	N	1	25
ProviderMiddleName	AN	N	1	25
ProviderID2	AN	N	2	80
ProviderID1	AN	Y	2	80
ProviderIDQualifier2	AN	N	2	3
ProviderIDQualifier1	AN	Y	2	3
PatientID2	AN	N	2	3
PatientIDQualifier2	AN	N	1	2
PatientID1	AN	N	1	30
PatientIDQualifier1	AN	N	2	3
CoverageLevel	AN	N	3	3
InNetwork	Boolean	N	1	5
PatientSSN	NUM	N	1	9
PatientAccountNumber	AN	N	1	80
FromDate	DT	N	10	10
ToDate	DT	N	10	10
SubscriberGroupNumber	AN	N	1	80
GroupID	AN	N	1	30
SubscriberPrefix	AN	N	1	10
SubscriberSuffix	AN	N	1	10
PatientPrefix	AN	N	1	10
PatientSuffix	AN	N	1	10
ProviderPrefix	AN	N	1	10
ProviderSuffix	AN	N	1	10