Section title: X12 EDI Examples
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ASC X12 Version: 008030 | Transaction Set: 278 | TR3 ID: 008030X328

Example 03 - Information Copy (BHT02 = 22)

The Service loop of courtesy copies of advance or completion notifications are identical in content to the notifications. The business event that triggers this transfer of information and the entities sending and receiving the information determine if the requirement is to notify the receiver, or provide information copies. The primary use of the information copy is to forward from a delegated entity to the Payer a copy of the contents of service reviews that were certified, or not certified by the notification sender/delegated entity. The following example demonstrates an information copy of a service review that was rejected based on the data content of Loop 2000F of the health care services review request.

Transmission Explanation

HL*5*4*SS*0~
AAA*N**52~
UM*HS*I*6~

The AAA segment indicates that the source rejected the service review request for radiation therapy due to an invalid or missing date of service.