RQA_I10

11.3.4 RQA/RPA - request for resubmission of an authorization (event I10)

8 segments

If a previously submitted request for treatment authorization is rejected or canceled, this event could trigger a resubmission message for a referenced authorization. For example, the payor may have rejected a request until additional clinical information is sent to support the authorization request.

Message Structure

8 segments
R RequiredO Optional Choice
MSH
R1
RF1
O1
AUTHORIZATION
O1
AUT
R1
CTD
O1
PROVIDER
R*
PRD
R1
CTD
O*
PID
R1
NK1
O*