| QUCR_HD200100UV01 Eligibility Query Request |
Description: Entry point for eligibility query request message (Link to Excel View) Derived from RMIM: QUCR_RM200000UV01 |
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| ParameterList | |||||||||
| id [1..1] (M) Parameter (II) |
Design Comments: Query Identifier |
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| carrierRole.id [0..1] (CarrierRole.id) | |||||||||
| coveredPartyAsPatient.Id [0..1] (CoveredPartyAsPatient.Id) | |||||||||
| coveredPartyAsPatientPerson.BirthTime [0..1] (CoveredPartyAsPatientPerson.BirthTime) | |||||||||
| coveredPartyAsPatientPerson.Name [1..1] (CoveredPartyAsPatientPerson.Name) | |||||||||
| coveredPartyAsPatientRole.Code [0..1] (CoveredPartyAsPatientRole.Code) | |||||||||
| policyOrAccount.Id [0..1] (PolicyOrAccount.Id) |
Design Comments: This parameter may not be present if the requestor does not know the policy id (e.g. WCB claim #). The association is required, so a NullFlavor is required to indicate why the policy number is not present in the query request. In the absence of policy id, then the name, date of birth and relationship code are required. |
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| serviceDate [1..1] (ServiceDate) | |||||||||
| CarrierRole.id | |||||||||
| value [1..1] (M) ParameterItem (II) |
Design Comments: Carrier ID |
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| CoveredPartyAsPatient.Id | |||||||||
| value [1..1] (M) ParameterItem (II) |
Design Comments: e.g. Personal Health Number, policy id + member number |
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| CoveredPartyAsPatientPerson.BirthTime | |||||||||
| value [1..1] (M) ParameterItem (TS) |
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| CoveredPartyAsPatientPerson.Name | |||||||||
| value [1..1] (M) ParameterItem (PN) |
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| CoveredPartyAsPatientRole.Code | |||||||||
| value [1..1] (M) ParameterItem (CS) |
Design Comments: Relationship to Policy Holder |
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| PolicyOrAccount.Id |
Design Comments: This parameter may not be present if the requestor does not know the policy id (e.g. WCB claim #). The association is required, so a NullFlavor is required to indicate why the policy number is not present in the query request. In the absence of policy id, then the name, date of birth and relationship code are required. |
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| value [1..1] (M) ParameterItem (II) |
Design Comments: Policy identifiers, including plan, group as required |
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| ServiceDate | |||||||||
| value [1..1] (M) ParameterItem (IVL<TS>) |
Design Comments: Service date |
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