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) |