AUT
Authorization Information
This segment represents an authorization or a pre-authorization for a referred procedure or requested service by the payor covering the patient's health care.
RRequiredOOptionalCConditionalWWithdrawn|#Date/Time*Backward compat.+Filler
10
| C.Len | Element | v2.5 | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 1 | ..250 | - | CWE | O | 1 | 0072 | 01146 | AUT-1 | Authorizing Payor, Plan ID | Data Type |
| 2 | ..250 | - | CWE | R | 1 | 0285 | 01147 | AUT-2 | Authorizing Payor, Company ID | Data Type |
| 3 | ..45 | - | ST | O | 1 | - | 01148 | AUT-3 | Authorizing Payor, Company Name | |
| 4 | ..24 | - | DTM | O | 1 | - | 01149 | AUT-4 | Authorization Effective Date | 2 |
| 5 | ..24 | - | DTM | O | 1 | - | 01150 | AUT-5 | Authorization Expiration Date | 2 |
| 6 | ..30 | - | EI | C | 1 | - | 01151 | AUT-6 | Authorization Identifier | |
| 7 | ..25 | - | CP | O | 1 | - | 01152 | AUT-7 | Reimbursement Limit | |
| 8 | ..2 | - | NM | O | 1 | - | 01153 | AUT-8 | Requested Number of Treatments | |
| 9 | ..2 | - | NM | O | 1 | - | 01154 | AUT-9 | Authorized Number of Treatments | |
| 10 | ..24 | - | DTM | O | 1 | - | 01145 | AUT-10 | Process Date | 2 |
7