EHC^E04
Re-Assess HealthCare Services Invoice Request
This message is used to submit a single Re-Assess HealthCare Services Invoice Request to a TPA/Payer for processing. The Re-Assess HealthCare Services Invoice Request is used by a Provider, to request review of a previously adjudicated HealthCare Services Invoice, with optional specification of a Product/Service Line Item within that Invoice. Note that the HealthCare Services Invoice need not necessarily be sent to a TPA/Payer using the EHC^E01 - Submit HealthCare Services Invoice: it may be manually submitted.
Adjudication for a HealthCare Services Invoice may be re-assessed either because background information, such as a Provider's billing rate may have changed or if some of the adjudication rules have changed since original adjudication of the Invoice.
Message Types
Message Type
Trigger Structure
Event Flow
TriggerE04
SendEHC_E04
ReceiveNUL