Inquiry Request Body

{ "senderId": "201985AAS", "submitterTransactionIdentifier": "1234567890", "payerId": "BCBSSC", "payerName": "South Carolina Blue Cross Blue", "umClearingHouseId": "000000000000001", "portalUsername": "portalUsername", "portalPassword": "portalPassword", "requester": { "requesterType": "1P", "organizationName": "Regional Medical Center", "lastName": "Regional Medical Center", "requesterIdentification": { "employerIdentificationNumber": "123456789" }, "city": "Orangeburg", "state": "SC", "postalCode": "12345", "npi": "1234567890", "contactTelephone": "803-395-2200" }, "subscriber": { "lastName": "TEST", "firstName": "BRITTANY", "memberId": "ZCS12345678", "dateOfBirth": "19701231", "supplementalIdentification": { "groupNumber": "123456789", "ssn": "111223333" } }, "patientEventDetail": { "requestCategoryCode": "HS", "certificationTypeCode": "I", "serviceTypeCode": "1", "facilityTypeCode": "11", "facilityCodeQualifier": "B", "eventDateBegin": "20231017", "eventDateEnd": "20231017", "patientEventProviderName": [ { "entityIdentifierCode": "SJ", "lastName": "TEST", "firstName": "STEVEN", "identificationCodeQualifier": "XX", "identifier": "1234567890" }, { "entityIdentifierCode": "DN", "lastName": "TEST", "firstName": "STEVEN", "identificationCodeQualifier": "XX", "identifier": "1234567890" } ], "serviceLevel": [ { "requestCategoryCode": "HS", "facilityTypeCode": "11", "facilityCodeQualifier": "B", "serviceDateBegin": "20231017", "serviceDateEnd": "20231017", "professionalService": { "productOrServiceIDQualifier": "HC", "procedureCode": "71260" } }, { "requestCategoryCode": "HS", "facilityTypeCode": "11", "facilityCodeQualifier": "B", "serviceDateBegin": "20231017", "serviceDateEnd": "20231017", "professionalService": { "productOrServiceIDQualifier": "HC", "procedureCode": "74177" } } ] } }

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