5.2 Profile for Correcting Post-usage Reports of New Claims and/or Invoice Details

A correction to a Claim Detail Message created in accordance Clause 5.1 comprises:

  1. One Header Record CDMH;

  2. One or more Basic Summary Records CS01, each followed by none, one or more financial/claim Summary Records CS02;

  3. None, one or more Blocks comprising:

    1. 1 CD02 Record providing essential information as originally communicated, as it is suggested to be corrected, and the difference between these two;

    2. 0-n CX01 Records providing auxiliary information that can be used to provide further details on the preceding CD02 record; and

  4. One Footer Record SRFO.


Details about these Record Types are provided in Part 2 of this Standard.

To indicate that a Claim Detail Message is created in accordance with Profile, the Profile Cell in the Header Record shall be set to BasicCDMCorPostUsage and the ProfileVersion Cell to 1.0.