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11.3.1 RQA/RPA - request patient authorization message

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)."

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