All trigger events in this group use the following message definition.
RQA Request Patient Authorization Chapter
MSH Message Header 2
[RF1] Referral Information 11
[
AUT Authorization Information 11
[CTD] Contact Data 11
]
{
PRD Provider Data 11
[{CTD}] Contact Data 11
}
PID Patient ID 3
[{NK1}] Next of Kin 6
[[{GT1}] Guarantor 6
{
IN1 Insurance 6
[IN2] Insurance, Additional info 6
[IN3] Insurance, Certification 6
}
]
[ ACC ] Accident 6
[{DG1}] Diagnosis Information 6
[{DRG}] DRG Information 6
[{AL1}] Allergy 3
[
{
PR1 Procedure 6
[
AUT Authorization Information 11
[CTD] Contact Data 11
]
}
]
[
{
OBR Observation Request 4
[{NTE}] Notes and Comments 2
[
{
OBX Results 7
[{NTE}] Notes and Comments 2
}
]
}
]
[
PV1 Patient Visit 3
[PV2] Patient Visit Additional Info 3
]
[{NTE}] Notes and Comments 2
RPA Return Patient Authorization Chapter
MSH Message Header 2
MSA Message Acknowledgment 3
[RF1] Referral Information 11
[
AUT Authorization Information 11
[CTD] Contact Data 11
]
{
PRD Provider Data 11
[{CTD}] Contact Data 11
}
PID Patient ID 3
[{NK1}] Next of Kin 6
[{GT1}] Guarantor 6
[
{
IN1 Insurance 6
[IN2] Insurance, Additional info 6
[IN3] Insurance, Certification 6
}
]
[ ACC ] Accident 6
[{DG1}] Diagnosis Information 6
[{DRG}] DRG Information 6
[{AL1}] Allergy 3
{
PR1 Procedure 6
[
AUT Authorization Information 11
[CTD] Contact Data 11
]
}
[
{
OBR Observation Request 4
[{NTE}] Notes and Comments 2
[
{
OBX Results 7
[{NTE}] Notes and Comments 2
}
]
}
]
[
PV1 Patient Visit 3
[PV2] Patient Visit Additional Info 3
]
[{NTE}] Notes and Comments 2
Note: The abstract message definitions for both the RPA and RQA include the patient visit segments (PV1 and PV2). The PV1 and PV2 segments appear in the RPA and RQA as an optional grouping to specify the visit or encounter that generated the referral authorization request. The PV1 and PV2 should not be used to provide suggested information for a future encounter or visit generated by the referral authorization request. |
The trigger events that use this message definition are described in Sections 11.3.2, "RQA/RPA - request for treatment authorization information XE "Request for treatment authorization information" (event I08)," through 11.3.5, "RQA/RPA - request for cancellation of an authorization XE "Request for cancellation of an authorization" (event I11)."