EHC_E20
EHC^E20 - Submit Authorization Request (event E20)
19 segments · 1 events
This message is used to submit a single Authorization Request to a TPA/Payer for authorization (for payment). An Authorization Request is made for one or more patients and may include 1 or more Product/Service Line Items (detail lines), each of which represents a specific, billable item or Payer allowed Treatment Plan.
If the Authorization is approved, then the Payer Application will return either an Authorization Number (Authorization Identifier on AUT) or individual who has authorized the Authorization Request (Name of Authorizer on AUT). The Authorization Number is not the same number as the Authorization Request Number; the latter indicates the number used to identify the request for authorization. The presence of the AUT segment in the EHC^E24 - Authorization Request Response message implies authorization. However, the Authorization may be restricted, which is described as Payer Adjustments.
Message Structure
19 segments
R RequiredO Optional Choice
MSH
R1SFT
O*UAC
O*AUTHORIZATION_REQUESTChoice
R1IVC
R1CTD
R*LOC
O*ROL
O*PAT_INFO
R*PID
R1ACC
O*INSURANCE
R*IN1
R1IN2
O1DIAGNOSIS
O*DG1
R1NTE
O*OBX
O*PSL_ITEM_INFO
R*PSL
R1NTE
O*ADJ
O*LOC
O*ROL
O*Used by Events:E20Submit Authorization Request