EHC^E20
Submit Authorization Request
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 Types
Message Type
Trigger Structure
Event Flow
TriggerE20
SendEHC_E20
ReceiveNUL