In the 005010X217 (278) request the Loop 2000E has a loop repeat of 1, whereas in the 278 response the loop 2000E can repeat more than once, what is the use case for this? When can the response receiver system expect multiple 2000E loops in the response.
While sending a 278 request, only 1 2000E loop can be sent, whereas while processing a response, multiple 2000E loops must be accounted for. What is the information sent in these 2000E loops in 005010X217?
For entities that submit a 2000E patient event level UM03 (Service Type) only when requesting services, there are business scenarios in which the requested service may not be approved, but an alternative service would be allowed. In these instances, the initial 2000E patient event level segment would return an HCR segment using an HCR01=A3 (Not Certified) for the UM03 value requested. An additional 2000E patient event level segment would be returned with an HCR segment using an HCR01=A6 (Modified) and report the UM03 value that can be used.
Related RFIs: 1057