Inquiry Request Body
{
"authorizationId": "26b887eb-17d0-4eee-bfec-a7c84e7b7959",
"inquiry": {
"x12": "ISA*00* *00* *ZZ*INQDEMO *ZZ*201985AAS *260728*1700*^*00501*636175853*0*P*:~GS*HI*TST1*201985AAS*20260728*170004*729173567*X*005010X215~ST*278*0001*005010X215~BHT*0007*49*1234567890*20260728*170004*18~HL*1**20*1~NM1*PR*2*SOUTH CAROLINA BLUE CROSS BLUE*****PI*TST1~PER*IC**UR*none~HL*2*1*21*1~NM1*1P*2*REGIONAL MEDICAL CENTER*****XX*1234567890~REF*EI*123456789~HL*3*2*22*0~NM1*IL*1*TEST*BRITTANY****MI*ZCS12345678~REF*6P*123456789~REF*SY*111223333~AAA*Y**72*C~DMG*D8*19701231~SE*15*0001~GE*1*729173567~IEA*1*636175853~",
"json": {
"submitterTransactionIdentifier": "1234567890",
"payerId": "TST1",
"payerName": "SOUTH CAROLINA BLUE CROSS BLUE",
"umClearingHouseId": "201985AAS",
"contactUrl": "none",
"umRequestValidation": null,
"requester": {
"requesterType": "1P",
"organizationName": "REGIONAL MEDICAL CENTER",
"requesterIdentification": {
"employerIdentificationNumber": "123456789"
},
"npi": "1234567890"
},
"subscriber": {
"subscriberRequestValidation": [
{
"responseCode": "Y",
"rejectReasonCode": "72",
"rejectReasonDescription": "Invalid/Missing Subscriber/Insured ID",
"rejectReasonExplanation": "The memberId is missing or does not match the payer's records.",
"followupActionCode": "C"
}
],
"lastName": "TEST",
"firstName": "BRITTANY",
"memberId": "ZCS12345678",
"dateOfBirth": "19701231",
"supplementalIdentification": {
"groupNumber": "123456789",
"ssn": "111223333"
}
},
"dependent": {
"supplementalIdentification": {}
}
}
}
}
Updated 13 days ago
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