This event triggers a message to be sent from one healthcare provider to another to request insurance information for a specified patient.
Segment | Cardinality | Implement | Status |
---|---|---|---|
RQI^I01^RQI_I01 | |||
MSH Message Header |
[1..1] | SHALL | |
ARV Access Restriction |
v2.9 | ||
SFT Software Segment |
|||
UAC User Authentication Credential Segment |
[0..1] | ||
PROVIDER | [1..*] | SHALL | |
PRD Provider Data |
[1..1] | SHALL | |
CTD Contact Data |
|||
PID Patient Identification |
[1..1] | SHALL | |
NK1 Next of Kin / Associated Parties |
|||
GUARANTOR_INSURANCE | [0..1] | ||
GT1 Guarantor |
|||
INSURANCE | [1..*] | SHALL | |
IN1 Insurance |
[1..1] | SHALL | |
IN2 Insurance Additional Information |
[0..1] | ||
IN3 Insurance Additional Information, Certification |
[0..1] | ||
NTE Notes and Comments |
MSH-15 | MSH-16 | Immediate ACK | Application Ack |
---|---|---|---|
Blank | Blank | - | ACK^I07^ACK |
Blank | Blank | - | RPR^I03^RPR_I03 |
Blank | Blank | - | RPL^I02^RPL_I02 |
Blank | Blank | - | RPI^I01^RPI_I01 |
NE | NE | - | - |
NE | AL | - | RPR^I03^RPR_I03 |
NE | AL | - | RPL^I02^RPL_I02 |
NE | AL | - | RPI^I01^RPI_I01 |
AL | NE | ACK^I07^ACK | - |
AL, SU, ER | AL | ACK^I03^ACK | RPR^I03^RPR_I03 |
AL, SU, ER | AL | ACK^I02^ACK | RPL^I02^RPL_I02 |
AL, SU, ER | AL | ACK^I01^ACK | RPI^I01^RPI_I01 |