HL7 Messages & Technical Specifications for Medical Services Plan
Technical specifications for HL7 messages are posted as individual documents. Collectively they are referred to as Volume 4 of the Software Compliance Standards documentation.
Developers can refer to the Transaction Dictionary in Volume 1 to determine which message specifications they require. Transaction business requirements are in Volume 3 publications.
The messages listed on this page have been approved for vendor development.
Unless otherwise indicated, the documents are in PDF format.
| ACK | General Acknowledgement |
| E45 | Query Eligibility |
| R15 | Check Beneficiary Coverage Status |
| R20 | Record Document |
| R30 | Establish Payer Relationship |
| R31 | Establish Payer Relationship for Dependent |
| R32 | Get Contract Periods |
| R34 | Update Employee Number and/or Department |
| R35 | End Payer Relationship |
| R36 | End Payer Relationship for Dependent |
| R37 | Get Account Contract Address |
| R38 | Update Account Contract Address |
| R40 | Account Contract Inquiry |
| R41 | New Payer Inquiry |
| R42 | PHN Lookup |
| R43 Z29 | Reinstate Overage Dependent |
| R44 Z28 | Reinstate Cancelled Coverage |
| R45 Z27 | Renew Cancelled Coverage |
| R46 Z26 | Update Premium Payment Periods |
| R50 | Enroll Subscriber |
| R50 Z03 | Enroll Subscriber with PHN |
| R50 Z04 | Enroll Subscriber without PHN |
| R50 Z05 | Enroll Visa Subscriber without PHN |
| R50 Z06 | Enroll Visa Subscriber with PHN |
| R51 | Extend Visa Resident Cancel Date |
| ALL |
Zipped Collection of Medical Services Plan Messages above (ZIP, 1.5MB) |
