TransmissionDateTime 14 Date Yes Date and Time when the Referral was sent by the CCAC to the Provider OfferDateTime 10 No Date and time when service was offered CcacCode 2 - 4 Alpha Yes A unique number for the CCAC. Valid values are: "ESC" |"SW" | "WW" | "HNHB" | "CW" | "MH" |"TC" | "CENT"| "CE"| "SE" | "CHAM"| "NSM"| "NE" | "NW" BillingReferenceNumber 12 Yes A code that identifies this Referral and quoted by the provider in their Billing Invoice ContractCode Max 20 Alpha / Yes Contract Number assigned to num Service Provider by the CCAC when the contract was entered into BillingCodes (element) No List of Billing Codes that may be applied to the services provided BillingCode (element) No Billing Code group containing the code and description Code Yes The code assigned based on the contracted service Description Yes The descriptive name of the billing code
TransmissionDateTime 14 Date Yes Date and Time when the Referral was sent by the CCAC to the Provider OfferDateTime 10 No Date and time when service was offered CcacCode 2 - 4 Alpha Yes A unique number for the CCAC. Valid values are: "ESC" |"SW" | "WW" | "HNHB" | "CW" | "MH" |"TC" | "CENT"| "CE"| "SE" | "CHAM"| "NSM"| "NE" | "NW" BillingReferenceNumber 12 Yes A code that identifies this Referral and quoted by the provider in their Billing Invoice ContractCode Max 20 Alpha / num Yes Contract Number assigned to Service Provider by the CCAC when the contract was entered into BillingCodes (element) No List of Billing Codes that may be applied to the services provided BillingCode (element) No Billing Code group containing the code and description Code Yes The code assigned based on the contracted service Description Yes The descriptive name of the billing code
CCAC_Service_Referral_Format_-_Specifications%20-%20v2.20.docx