Membership number formats

We’ve got access to the membership databases for Aviva, AXA Health, Bupa and Vitality and invoices are validated against these. The other insurers validate against membership number formatting rules.

The validation format criteria are set out for each insurer and use the following key:

• A = Letter
• N = Number
• X = Letter or Number

A couple of examples:

• AANNNN = 2 letters followed by 4 numbers
• NNNNNNXXA = 6 numbers, followed by 2 characters than can either be a number or a letter, followed by a letter

Where other letters and specific letters or symbols are used, this is clearly shown.

Alliance Health

There are three formats that are recognised.

• NNNNNN = 6 numbers
• NNNNNNN = 7 numbers
• NNNNNNNN = 8 numbers

Allianz Partners

The letter P followed by between 4 to 9 numbers.

As Allianz are now processing invoices on behalf of Aetna for their Americas policy holders, the following formats are also recognised. More information on what that means can be found here.

• WNNNNNNNNN = the letter W, followed by 9 numbers
• WNNNNNNNNN-NN = the letter W, followed by 9 numbers, followed by a hyphen (-), followed by 2 numbers
• WNNNNNNNNNN = the letter W, followed by 10 numbers
• WNNNNNNNNNN-NN = the letter W, followed by 10 numbers, followed by a hyphen (-), followed by 2 numbers
• WNNNN⎵NNNNN = the letter W, followed by 4 numbers, followed by a space, followed by 5 numbers
• WNNNN⎵NNNNN-NN = the letter W, followed by 4 numbers, followed by a space, followed by 5 numbers, followed by a hyphen (-), followed by 2 numbers
• WNNNN⎵NNNNNN = the letter W, followed by 4 numbers, followed by a space, followed by 6 numbers
• WNNNN⎵NNNNNN-NN = the letter W, followed by 4 numbers, followed by a space, followed by 6 numbers, followed by a hyphen (-), followed by 2 numbers

Bupa Global

Must be 17 characters long.

• XX-NNNN-NNNN-NNNN = 2 characters (often the letters BI), followed by a hyphen (-), followed by 4 numbers, followed by a hyphen (-), followed by 4 numbers, followed by a hyphen (-), followed by 4 numbers

Exeter Friendly

There are seven formats that are recognised.

• NNNNN = 5 numbers
• NNNNNN = 6 numbers
• NNNNNNN = 7 numbers
• NNNNNNNNNN = 10 numbers
• NNNNNNNNPPNN = 8 numbers, followed by the letter P, followed by the letter P, followed by 2 numbers
• WINNNNNNNN = the letter W, followed by the letter I, followed by 8 numbers
• WDNNNNNNNN = the letter W, followed by the letter D, followed by 8 numbers

WPA

There are five formats that are recognised.

• NNNNN = 5 numbers
• NNNNNN = 6 numbers
• NNNNNNN = 7 numbers
• NNNNNNNN = 8 numbers
• NNNNNNNNN = 9 numbers

The post Validation Rules | Membership numbers appeared first on Healthcode.

Authorisation number formats

Getting your patient pre-authorised gives you peace of mind that their policy allows them to have the requested treatment. But remember, it’s not a guarantee of payment. Adding the pre-authorisation number (sometimes also known as claim number or patient assessment number) onto your invoice shows the insurer that someone has been in touch prior to treatment to let them know what’s going on. If you’re going to add it you need to make sure the format is correct to stop your invoices failing validation.

The pre-authorisation number is optional for the insurers, unless otherwise stated. The only insurer that doesn’t validate these is AXA Health, so we haven’t included the format requirements in this guide.

The validation format criteria are set out for each insurer and use the following key:

• A = Letter
• N = Number
• X = Letter or Number

A couple of examples:

• AANNNN = 2 letters followed by 4 numbers
• NNNNNNXXA = 6 numbers, followed by 2 characters than can either be a number or a letter, followed by a letter

Where other letters and specific letters or symbols are used, this is clearly shown.

Alliance Health

There are two formats that’ll pass validation.

• AAANNNNN = 3 letters, followed by 5 numbers
• A-ANNNNN = a letter, followed by a hyphen (-), followed by a letter, followed by 5 numbers

Allianz Partners

There’s no set length – it can be a combination of letters, numbers and can also include a hyphen.

Aviva

There are four formats that’ll pass validation.

• NNNNNN/NN/NNNN/NNN = 6 numbers, followed by a forward slash (/), followed by 2 numbers, followed by a forward slash, followed by 4 numbers, followed by a forward slash, followed by 3 numbers
• NNNNNN\NN\NNNN\NNN = 6 numbers, followed by a backslash (\), followed by 2 numbers, followed by a backslash, followed by 4 numbers, followed by a backslash, followed by 3 numbers
• NNNNNN/NN = 6 numbers, followed by a forward slash (/), followed by 2 numbers
• NNNNNN\NN = 6 numbers, followed by a backslash (\), followed by 2 numbers

Bupa

There’s no set length – it must be all numbers.

Bupa Global

There are two formats that will pass validation, both must start with the letter A:

• ANNNNNNN = the letter A, followed by 7 numbers
• ANNNNNNNN = the letter A, followed by 8 numbers

Healix

There’s no set length – it can be a combination of letters and numbers.

Trust in Health

You must include a pre-authorisation number on any invoice. It must start with THP, followed by a letter and 6 numbers.

VitalityHealth

There are three formats that’ll pass validation and all must start with the number 1, 5 or 9.

• NNNNNN = 6 numbers but the first must be a 1, 5 or 9
• NNNNNNN = 7 numbers but the first must be a 1, 5 or 9
• NNNNNNNN = 8 numbers but the first must be a 1, 5 or 9

WPA

There are two formats that’ll pass validation.

• NNNNNNNNN = 9 numbers
• XXXXXX = 6 characters – can be any combination of letters and numbers

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