You are here : Funding  >  MACSIS / MITS  >  Claims  >  Benef Sample
BENEF Explanation (Sample)

SAMPLE BENEFIT PLAN AND BRULES
FOR MONTGOMERY COUNTY UNDER HIPAA

BENEFIT PLAN BRULES ATTACHED
57B00001 STANDARD TX
30 BRULES

ADMCDDAYS

ADMCDOUTP1

ADMCDOUTP2

OHINVALID

MHPARHOSPA

MHPARHOSPC

570000000560 STD NONMCD EXCLUS-1

5700000007 60 STD NONMCD EXCLUS-3

5700000008 60 STD NONMCD EXCLUS-4

ALL SUBSIDY RULES (21)

57B00002 OUT OF COUNTY PLAN
31 BRULES

ADMCDDAYS

ADMCDOUTP1

ADMCDOUTP2

OHINVALID

MHPARHOSPA

MHPARHOSPC

5700000005 60 STD NONMCD EXCLUS-1

5700000007 60 STD NONMCD EXCLUS-3

5700000008 60 STD NONMCD EXCLUS-4

5700000013 50 OOC HOLDS #1

ALL SUBSIDY RULES (21)

57B00003 PREVENTION AND ADJ. SRVS PLAN
7 BRULES

ADMCDDAYS

ADMCDOUTP1

ADMCDOUTP2

OHINVALID

MHPARHOSPA

MHPARHOSPC

5700000012 60 PREV/ADJUNC ONLY

57B00004 MH ONLY
33 BRULES

ADMCDDAYS

ADMCDOUTP1

ADMCDOUTP2

OHINVALID

MHPARHOSPA

MHPARHOSPC

5700000001 60 MH ONLY PLAN

5700000005 60 STD NONMCD EXCLUS-1

5700000007 60 STD NONMCD EXCLUS-3

5700000008 60 STD NONMCD EXCLUS-4

57FY200106 50 STD NONMCD EXCLUS-2

57B2002 60 NEW MEDEF EXCLUSION

ALL SUBSIDY RULES(21)