To better understand the relationship of the row values for each attachment activity, a “table interpretation template” was developed: Table interpretation template: Activity “Activity ID” represents the information exchange for the “Healthcare Administrative Activity” “Solicited / Unsolicited” “Originator Activity Type” for Attachments from the “Originator” to the “receiver”. By substituting the row values found for each of the heading columns identified in “BOLD” type, a high level use case description can be created. The following examples are derived from the table using the template above: Claim Attachment Scenarios () Activity #1 represents the information exchange for the Claims Attachment solicited request from the payer to the provider. Activity #2 represents the information exchange for the Claims Attachment solicited response from the provider to the payer. Activity #3 represents the information exchange for the Claims unsolicited Attachment submission from the provider to the payer. Prior Authorization Attachment Scenarios () Activity #4 represents the information exchange for the rior uthorization Attachment solicited request from the payer to the provider. Activity #5 represents the information exchange for the rior uthorization solicited response from the provider to the payer. Activity #6 represents the information exchange for the rior uthorization unsolicited Attachment submission from the provider to the payer. Referral Attachment Scenarios () Activity #7 represents the information exchange for the Referral Attachment solicited request from the payer/referred to provider to the referring provider. Activity #8 represents the information exchange for the Referral Attachment solicited response from the referring provider to the payer/referred to provider. Activity #9 represents the information exchange for the eferral unsolicited Attachment submission from the referring provider to the payer/referred to provider. Notification Attachment Scenarios () Activity #10, represents the information exchange for the otification unsolicited Attachment submissions from the facility provider to the primary care provider.
To better understand the relationship of the row values for each attachment activity, a “table interpretation template” was developed: Table interpretation template: Activity “Activity ID” represents the information exchange for the “Healthcare Administrative Activity” “Solicited / Unsolicited” “Originator Activity Type” for Attachments from the “Originator” to the “receiver”. By substituting the row values found for each of the heading columns identified in “BOLD” type, a high level use case description can be created. The following examples are derived from the table using the template above: Claim Attachment Scenarios () Activity #1 represents the information exchange for the Claims Attachment solicited request from the payer to the provider. Activity #2 represents the information exchange for the Claims Attachment solicited response from the provider to the payer. Activity #3 represents the information exchange for the Claims unsolicited Attachment submission from the provider to the payer. Prior Authorization Attachment Scenarios () Activity #4 represents the information exchange for the rior uthorization Attachment solicited request from the payer to the provider. Activity #5 represents the information exchange for the rior uthorization solicited response from the provider to the payer. Activity #6 represents the information exchange for the rior uthorization unsolicited Attachment submission from the provider to the payer. Referral Attachment Scenarios () Activity #7 represents the information exchange for the Referral Attachment solicited request from the payer/referred to provider to the referring provider. Activity #8 represents the information exchange for the Referral Attachment solicited response from the referring provider to the payer/referred to provider. Activity #9 represents the information exchange for the eferral unsolicited Attachment submission from the referring provider to the payer/referred to provider. Notification Attachment Scenarios () Activity #10, represents the information exchange for the otification unsolicited Attachment submissions from the facility provider to the primary care provider.
HL7%20Attachment%20Supplement%20Specification_Request%20and%20Response%20Implementation%20Guide%20Release%202%20Balloted%20Version%203.3.DM.docx