Name of Organization) 250 Alpha No The name of the sender or the recipient organization OwnerOrganization (child of Organization) - - Yes Specifies the organization of the sender or the recipient Code (attribute of OwnerOrganization) 50 Yes Specifies the unique code of the sender or the recipient owner organization Type (attribute of OwnerOrganization) 150 No Specifies the type of the sender or the recipient organization. Valid content is “CCAC”, “Provider” or “Vendor”. If not provided the “CCAC” type is assumed. Name (child element of OwnerOrganization) 250 Alpha No The name of the sender or the recipient owner organization ProviderAssignmentId 25 Alpha / num Yes A CCAC assigned number that uniquely identifies this item ServiceAssignmentId 25 Alpha / (GUID) Yes A CCAC assigned number that uniquely identifies service assignment for the referral. This number can be retrieved from the ServiceReferral and ServiceFrequencyUpdate messages OfferId Max 25 Alpha / num No The unique identifier for the associated with this Referral OrganizationCode 10 Yes A unique number assigned to Vendor by local CCAC. Reference may be “provider” or “vendor” organization Num Num
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
ServiceDeliveryType 50 Alpha / num No Name of the Service Delivery Type ServiceDeliveryTypeCode 20 / num No Code of the Service Delivery Type Outcome-Based Pathway Assignment element detail Name Field Length (bytes) Type Description CarePathwayTitle 100 Alpha / num Yes Title of the Outcome-Based Pathway [ICC_Care_Paths].[Title] 255 Alpha / num No URL of the published Pathway Best Practices document for this Pathway [ICC_Care_Paths].[Document_Url] 255 Alpha / num No Description of the Outcome-Based Pathway [ICC_Care_Paths].[Description] CarePathwayCode 20 Alpha / num No Code identifying the Outcome-Based Pathway [ICC_Care_Paths].[Care_Path_Code]
Appendix B - Service Delivery Type The following table provides the Service Delivery Type Code, as well as Specialty, Unit of Delivery, and Service Location, by Service Type Code Correlating Service attributes Service Type Service Delivery Type Code Specialty Unit of Delivery Service Location Children’s Treatment Network Referrals NUT dietician - Children's Treatment Network Visit Home OT Visit OT - Children's Treatment Network Visit Home PT PT - Children's Treatment Network Visit Home SP Hourly speech - CTN Hour Home SP Visit speech - Children's Treatment Network Visit Home SW social work - Children's Treatment Network Home Home Care Referrals AMB Ambulance trip - one way Home AT Hourly attendant care Hour Home AT Visit attendant care Visit Home DP Visit Adult Day Program accessed via CCAC Visit Home ENT Hourly ENT home care Hour Home ENT Hourly ENT Palliative Home Care Palliative Hour Home ENT Visit ENT combined nursing & therapy day clinic Visit Combined Day Clinic ENT Visit ENT combined nursing & therapy day/night clinic Visit Combined Day/Night Clinic ENT Visit ENT home care Visit Home ENT Visit ENT nursing only clinic Visit Nursing Day Clinic ENT Visit ENT Palliative Home Care Palliative Home ENT ENT primary care practice Visit Primary Care Practice ENT ENT Residential Hospice Visit Residential Hospice
ER Hourly Children's Enhanced Respite home care Hour Home GER Visit Psychogeriatric Resource Coordination home care Visit Home HOM Hourly Homemaking - Caregiver Respite home care Homemaking – Caregiver Respite Hour Home HOM Hourly Homemaking - Combined personal support & housekeeping home care Combined Personal Support and Housekeeping Hour Home HOM Hourly Homemaking - Housekeeping home care Homemaking - Housekeeping Hour Home HOM Hourly Personal Support Home Care Homemaking - Personal Support Hour Home HOM Hourly Personal Support Residential Hospice Homemaking - Personal Support Hour Residential Hospice HOM Homemaking - Combined home care Combined Personal Support and Housekeeping Visit Home HOM Visit Homemaking - Housekeeping home care Homemaking - Housekeeping Visit Home HOM Visit Homemaking - Respite home care Homemaking - Caregiver Respite Visit Home HOM Visit Personal Support home care Homemaking - Personal Support Visit Home LAB Visit Lab home care Visit Home MOW Meals on Wheels CCAC Visit Home NP Hourly Nurse Practitioner home care Hour Home NP Visit Nurse Practitioner home care Visit Home NUR Hourly nursing home care Hour Home NUR Shift nursing combined therapy & nursing day clinic Hour Combined Day Clinic NUR Shift nursing combined therapy & nursing day/night clinic Hour Combined Day/Night Clinic NUR Shift nursing home care Hour Home NUR nursing nursing only day clinic Hour Nursing Day Clinic
OT OT combined nursing & therapy day/night clinic Visit Combined Day/Night Clinic OT Visit OT home care Visit Home OT Visit OT home care hourly Hour Home OT Visit OT Residential Hospice Visit Residential Hospice OT Visit OT therapy only day clinic Therapy Day Clinic PAS Visit Pastoral Care home care Visit Home PHA Hourly Pharmacy Consultation home care Hour Home PHA Visit Pharmacy Consultation home care Visit Home PHY Visit Physician home care Visit Home PHY Visit Physician Palliative Home Care Palliative Visit Home PM Visit paramedical Visit Home PSM Pain & Sympton Mgmt phone call Visit Phone PSM Pain & Sympton Mgmt home care Home PSY Visit Psychologist home care Visit Home PT Hourly PT home care Hour Home PT Visit PT combined nursing & therapy day clinic Visit Combined Day Clinic PT Visit PT combined nursing, therapy day/night clinic Visit Combined Day/Night Clinic PT Visit PT home care Visit Home PT Visit PT phone call Visit Phone PT Visit PT Pulmonary Rehab Home Care PT - Pulmonary Rehab Visit Home PT Visit PT Residential Hospice Visit Residential Hospice PT Visit PT therapy only day clinic Visit Therapy Day Clinic RT Hourly RT home care Hour Home RT Visit RT combined nursing, therapy day clinic Visit Combined Day Clinic RT RT combined nursing, therapy day/night clinic Visit Combined Day/Night Clinic RT Visit RT home care Visit Home