Default Tertiary Policy


Field DescriptionField ID
Tertiary Payer Name@INS3
Tertiary Policy Group #@INS3GRP
Tertiary Policy Member ID@INS3MEM
Tertiary Payer Address 1@INS3ADDR
Tertiary Payer Address 2@INS3ADDR2
Tertiary Payer City@INS3CITY
Tertiary Payer State@INS3STATE
Tertiary Payer Zip@INS3ZIP
Tertiary Payer Phone@INS3PH
Tertiary Payer Copay@TCOP
Tertiary Policy Co-Insurance@TCOINS
Tertiary Patient Deductible@TDEDUCT