EHC^E12
Request Additional Information
Reimbursement
A Payer or TPA uses this message to request additional information in support of an Invoice or a (Pre) Authorization Request. Normally, this request would be sent following receipt of an E01 or E20 message. However, it can also be sent following receipt of an E04 Re-Assess HealthCare Services Invoice Request. In this latter case the request for additional information still has as its object the original invoice (which is now under review) rather than the Re-assessment request per se.
The E12 can only be used to initiate a request for information and cannot be used to modify, place on hold or cancel an earlier request. This message cannot be used to convey information on the status of a claim and/or adjudication results (i.e., cannot be used in place of an E10 Edit/Adjudication Results message).
Message Types
Message Type
Trigger Structure
Event Flow
TriggerE12
SendEHC_E12
ReceiveNUL