Table 7: ASC X12N Attachment Activity Healthcare Administrative Activity Activity ID Originator Activity Type Attachment Activity Basis Actor Example Figure ID ASC X12N Envelope/ Transaction Standard Example Solicited Unsolicited Originator Receiver Claims Attachment #1 Request X Payer Provider 2771 #2 Response X Provider Payer 2752 #3 Attachment Submission X Provider Payer 2752 Auth Attachment #4 Request X Payer Provider 2783 #5 Response X Provider Payer 2754 #6 Attachment Submission X Provider Payer 2754 Referral Attachment #7 Request X Payer/ Referring Provider Referred To Provider 2783 #8 Response X Referred To Provider Payer/ Referring Provider 2754 #9 Attachment Submission X Referred To Provider Payer/ Referring Provider 2754 Post Adjudicated Claim Attachment #10 Request X Payer Provider 2771 #11 Response X Provider Payer 2752 Notification Attachment #12 Attachment Submission X Facility provider Primary care provider 2754 1 ASC X12N 277 – Health Care Information Status Notification - Technical Report Type 3 for Health Care Claim Request for Additional Information 2 ASC X12N 275 – Patient Information – Technical Report 3 for Additional Information to Support a Health Care or Encounter 3 ASC X12N 278 – Health Care Services Review Information Technical Report 3 for Health Care Services Request for Review and Response 4 ASC X12N 275 – Patient Information – Technical Report 3 for Additional Information to Support a Health Care Service Review Trial
OID - An ISO Object Identifier is a globally unique string consisting of numbers and dots (e.g., 2.16.840.1.113883.3.1). This string expresses a tree data structure, with the left-most number representing the root and the right-most number representing a leaf ONC – Office of the National Coordinator S&I – Standards and Interoperability – initiatives supported by ONC to identify and promote standards for interoperability Solicited Attachment - Refers to additional information submitted to a in response to a near-term request from the payer STU –Standard for Use – an HL7 designation for a standard or implementation guide that is on a path to become a normative standard. Payer - Refers to a healthcare entity, such as a health insurance company or UMO, that receives and process claims, prior authorizations and referrals PDF – Portable Document Format is a file format developed by Adobe as a means of distributing compact, platform-independent documents Plain Text – text with no embedded formatting codes PNG – Portable Network Graphics is a bitmapped image format that employs lossless data compression. RFC – Request for Comments in the context of this document refers to Internet Engineering Task tools. RTF – Rich Text Format -- a proprietary document file format with published specification developed by Microsoft Corporation Style sheet - Specification used by browsers for controlling the display of the markup language (e.g., XML or HTML), decribing how elements of a document should be displayed. Structured Document – a CDA header paired with a structuredBody element. TIFF – Tagged Image Format used for scanned images Triggering Event – an event such as a claim submission or request for prior authorization that may result in a request for additional information. Triggering Events in this document are for reference only and out of scope. UMO – Utilization Management Organization Unsolicited Attachment - Refers to additional information submitted to a payer but done so based on advance knowledge of this information need (e.g., rules based on medical policy) rather than in response to a near-term request from the payer. Unstructured Document – a CDA header paired with a nonXMLbody element ASC X12 ASC X12N has created several standards for enveloping the Attachment and providing acknowledgments for each transaction exchange.