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This section contains examples of MIME Multipart messages depicting the request and response required for patient eligibility checks.
The MIME EDI messaging envelope contains metadata related to its payload and may sometimes not contain the payload it describes. Fields common to all the messaging envelopes are:
| • | PayloadType: Identifies the kind of transaction the message is transmitting. Not all payload types are tied to a specific EDI transaction, some may be for confirmations of message arrival or error notifications. |
| • | ProcessingMode: Identifies whether the message is to be processed in real time or batch modes. |
| • | PayloadID: Unique identifier for the related payload. The payload does not need to be in the message; the message may be an acknowledgement of a received request. |
| • | TimeStamp: Time in which the message was sent. |
| • | SenderID: Identifies the sender of the message. |
| • | ReceiverID: Identifies the recipient of the message. |
| • | CORERuleVersion: Idenfities the CORE rules in effect. Currently 2.2.0. |
Request messages will always contain a header through which the sender is verified as an authorized user of the receiving service. This verification can be done through username/password tokens or the use of an x.509 certificate. The examples provided use the former method, as does HIPAAsuite RealTime Server.
The response message will not contain a header, but does have two additional fields for error processing: ErrorCode and ErrorMessage.
The MIME message envelopes for real time transactions are almost identical. Their only difference is the aforementioned distinction between request and response messages. The response in real time is meant to answer the request in full. The following are examples of a real time request and a real time response.
Real time Eligibility Request message:
POST /core/eligibility HTTP/1.1
Host: server_host:server_port
Content-Length: 2408
Content-Type: multipart/form-data; boundary=XbCY
--XbCY
Content-Disposition: form-data; name="PayloadType"
X12_270_Request_005010X279A1
--XbCY
Content-Disposition: form-data; name="ProcessingMode"
RealTime
--XbCY
Content-Disposition: form-data; name="PayloadID"
e51d4fae-7dec-11d0-a765-00a0c91e6da6
--XbCY
Content-Disposition: form-data; name="TimeStamp"
2007-08-30T10:20:34Z
--XbCY
Content-Disposition: form-data; name="UserName"
hospa
--XbCY
Content-Disposition: form-data; name="Password"
8y6dt3dd2
--XbCY
Content-Disposition: form-data; name="SenderID"
HospitalA
--XbCY
Content-Disposition: form-data; name="ReceiverID"
PayerB
--XbCY
Content-Disposition: form-data; name="CORERuleVersion"
2.2.0
--XbCY
Content-Disposition: form-data; name="Payload"
<contents of file go here -- 1674 bytes long as specified above>
--XbCY--
Real Time Eligibility Response Message:
HTTP/1.1 200 OK
Content-Length: 2408
Content-Type: multipart/form-data; boundary=XbCY
--XbCY
Content-Disposition: form-data; name="PayloadType"
X12_271_Response_005010X279A1
--XbCY
Content-Disposition: form-data; name="ProcessingMode"
RealTime
--XbCY
Content-Disposition: form-data; name="PayloadID"
f81d4fae-7dec-11d0-a765-00a0c91e6da6
--XbCY
Content-Disposition: form-data; name="TimeStamp"
2007-08-30T10:20:34Z
--XbCY
Content-Disposition: form-data; name="SenderID"
PayerB
--XbCY
Content-Disposition: form-data; name="ReceiverID"
HospitalA
--XbCY
Content-Disposition: form-data; name="CORERuleVersion"
2.2.0
--XbCY
Content-Disposition: form-data; name="ErrorCode"
Success
--XbCY
Content-Disposition: form-data; name="ErrorMessage"
None
--XbCY
Content-Disposition: form-data; name="Payload"
<contents of file go here -- 1674 bytes long as specified above>
--XbCY--
Batch messages, unlike the real time messages, won't necessarily contain a payload. Some messages (Batch Retrieval Requests, Batch Submission Acknowledgement Retrieval Requests, Batch Submission Responses, and Batch Results Acknowledgement Submission Responses) exist to confirm the arrival of a payload at the receiving end of the transaction.
In addition to the fields in the real time MIME messages, batch MIME messages have the following fields whenever a payload is included in the message:
| • | PayloadLength: Defines the length of the actual payload in bytes. |
| • | Checksum: An element used to allow the receiver to verify the integrity of the included payload. |
Batch Submission message:
POST /core/eligibility HTTP/1.1
Host: server_host:server_port
Content-Length: 244508
Content-Type: multipart/form-data; boundary=XbCY
--XbCY
Content-Disposition: form-data; name="PayloadType"
X12_270_Request_005010X279A1
--XbCY
Content-Disposition: form-data; name="ProcessingMode"
Batch
--XbCY
Content-Disposition: form-data; name="PayloadID"
f81d4fae-7dec-11d0-a765-00a0d91e6fa6
--XbCY
Content-Disposition: form-data; name="PayloadLength"
10240
--XbCY
Content-Disposition: form-data; name="TimeStamp"
2007-08-30T10:20:34Z
--XbCY
Content-Disposition: form-data; name="UserName"
hospa
--XbCY
Content-Disposition: form-data; name="Password"
8y6dt3dd2
--XbCY
Content-Disposition: form-data; name="SenderID"
HospitalA
--XbCY
Content-Disposition: form-data; name="ReceiverID"
PayerB
--XbCY
Content-Disposition: form-data; name="CORERuleVersion"
2.2.0
--XbCY
Content-Disposition: form-data; name="Checksum"
6A3FE55946
--XbCY
Content-Disposition: form-data; name="Payload"
<contents of batch file go here>
--XbCY--
Batch Submission Response message:
HTTP/1.1 200 OK
Content-Length: 2408
Content-Type: multipart/form-data; boundary=XbCY
--XbCY
Content-Disposition: form-data; name="PayloadType"
X12_BatchReceiptConfirmation
--XbCY
Content-Disposition: form-data; name="ProcessingMode"
Batch
--XbCY
Content-Disposition: form-data; name="PayloadID"
f81d4fae-7dec-11d0-a765-00a0c91e6da6
--XbCY
Content-Disposition: form-data; name="TimeStamp"
2007-08-30T10:20:34Z
--XbCY
Content-Disposition: form-data; name="SenderID"
PayerB
--XbCY
Content-Disposition: form-data; name="ReceiverID"
HospitalA
--XbCY
Content-Disposition: form-data; name="CORERuleVersion"
2.2.0
--XbCY
Content-Disposition: form-data; name="ErrorCode"
Success
--XbCY
Content-Disposition: form-data; name="ErrorMessage"
None
--XbCY--
Batch Submission Acknowledgement Retrieval Request message:
POST /core/eligibility HTTP/1.1
Host: server_host:server_port
Content-Length: 244508
Content-Type: multipart/form-data; boundary=XbCY
--XbCY
Content-Disposition: form-data; name="PayloadType"
X12_999_RetrievalRequest_005010X231A1
--XbCY
Content-Disposition: form-data; name="ProcessingMode"
Batch
--XbCY
Content-Disposition: form-data; name="PayloadID"
f81d4fae-7dec-11d0-a765-00a0d91e6fa6
--XbCY
Content-Disposition: form-data; name="TimeStamp"
2007-08-30T10:20:34Z
--XbCY
Content-Disposition: form-data; name="UserName"
hospa
--XbCY
Content-Disposition: form-data; name="Password"
8y6dt3dd2
--XbCY
Content-Disposition: form-data; name="SenderID"
HospitalA
--XbCY
Content-Disposition: form-data; name="ReceiverID"
PayerB
--XbCY
Content-Disposition: form-data; name="CORERuleVersion"
2.2.0
--XbCY--
Batch Submission Acknowledgement Retrieval Response message:
HTTP/1.1 200 OK
Content-Length: 12648
Content-Type: multipart/form-data; boundary=XbCY
--XbCY
Content-Disposition: form-data; name="PayloadType"
X12_999_Response_005010X231A1
--XbCY
Content-Disposition: form-data; name="ProcessingMode"
Batch
--XbCY
Content-Disposition: form-data; name="PayloadID"
f81d4fae-7dec-11d0-a765-00a0c91e6da6
--XbCY
Content-Disposition: form-data; name="PayloadLength"
10240
--XbCY
Content-Disposition: form-data; name="TimeStamp"
2007-08-30T10:20:34Z
--XbCY
Content-Disposition: form-data; name="SenderID"
PayerB
--XbCY
Content-Disposition: form-data; name="ReceiverID"
HospitalA
--XbCY
Content-Disposition: form-data; name="CORERuleVersion"
2.2.0
--XbCY
Content-Disposition: form-data; name="Checksum"
6A3FE55946
--XbCY
Content-Disposition: form-data; name="Payload"
<contents of batch file go here>
--XbCY
Content-Disposition: form-data; name="ErrorCode"
Success
--XbCY
Content-Disposition: form-data; name="ErrorMessage"
None
--XbCY--
Batch Results Retrieval Request message:
POST /core/eligibility HTTP/1.1
Host: server_host:server_port
Content-Length: 244508
Content-Type: multipart/form-data; boundary=XbCY
--XbCY
Content-Disposition: form-data; name="PayloadType"
X12_005010_Request_Batch_Results_271
--XbCY
Content-Disposition: form-data; name="ProcessingMode"
Batch
--XbCY
Content-Disposition: form-data; name="PayloadID"
f81d4fae-7dec-11d0-a765-00a0d91e6fa6
--XbCY
Content-Disposition: form-data; name="TimeStamp"
2007-08-30T10:20:34Z
--XbCY
Content-Disposition: form-data; name="UserName"
hospa
--XbCY
Content-Disposition: form-data; name="Password"
8y6dt3dd2
--XbCY
Content-Disposition: form-data; name="SenderID"
HospitalA
--XbCY
Content-Disposition: form-data; name="ReceiverID"
PayerB
--XbCY
Content-Disposition: form-data; name="CORERuleVersion"
2.2.0
--XbCY--
Batch Retrieval Response message:
HTTP/1.1 200 OK
Content-Length: 12648
Content-Type: multipart/form-data; boundary=XbCY
--XbCY
Content-Disposition: form-data; name="PayloadType"
X12_271_Response_005010X279A1
--XbCY
Content-Disposition: form-data; name="ProcessingMode"
Batch
--XbCY
Content-Disposition: form-data; name="PayloadID"
f81d4fae-7dec-11d0-a765-00a0c91e6da6
--XbCY
Content-Disposition: form-data; name="PayloadLength"
10240
--XbCY
Content-Disposition: form-data; name="TimeStamp"
2007-08-30T10:20:34Z
--XbCY
Content-Disposition: form-data; name="SenderID"
PayerB
--XbCY
Content-Disposition: form-data; name="ReceiverID"
HospitalA
--XbCY
Content-Disposition: form-data; name="CORERuleVersion"
2.2.0
None
--XbCY
Content-Disposition: form-data; name="Checksum"
6A3FE55946
--XbCY
Content-Disposition: form-data; name="Payload"
<contents of batch file go here>
--XbCY
Content-Disposition: form-data; name="ErrorCode"
Success
--XbCY
Content-Disposition: form-data; name="ErrorMessage"
None
--XbCY--
Batch Results Acknowledgement Submission message:
POST /core/eligibility HTTP/1.1
Host: server_host:server_port
Content-Length: 244508
Content-Type: multipart/form-data; boundary=XbCY
--XbCY
Content-Disposition: form-data; name="PayloadType"
X12_999_SubmissionRequest_005010X231A1
12
--XbCY
Content-Disposition: form-data; name="ProcessingMode"
Batch
--XbCY
Content-Disposition: form-data; name="PayloadID"
f81d4fae-7dec-11d0-a765-00a0d91e6fa6
--XbCY
Content-Disposition: form-data; name="PayloadLength"
10240
--XbCY
Content-Disposition: form-data; name="TimeStamp"
2007-08-30T10:20:34Z
--XbCY
Content-Disposition: form-data; name="UserName"
hospa
--XbCY
Content-Disposition: form-data; name="Password"
8y6dt3dd2
--XbCY
Content-Disposition: form-data; name="SenderID"
HospitalA
--XbCY
Content-Disposition: form-data; name="ReceiverID"
PayerB
--XbCY
Content-Disposition: form-data; name="CORERuleVersion"
2.2.0
--XbCY
Content-Disposition: form-data; name="Checksum"
6A3FE55946
--XbCY
Content-Disposition: form-data; name="Payload"
<contents of batch file go here>
--XbCY--
Batch Results Acknowledgement Submission Response message:
HTTP/1.1 200 OK
Content-Length: 2408
Content-Type: multipart/form-data; boundary=XbCY
--XbCY
Content-Disposition: form-data; name="PayloadType"
X12_Response_ConfirmReceiptReceived
--XbCY
Content-Disposition: form-data; name="ProcessingMode"
Batch
--XbCY
Content-Disposition: form-data; name="PayloadID"
f81d4fae-7dec-11d0-a765-00a0d91e6fa6
--XbCY
Content-Disposition: form-data; name="TimeStamp"
2007-08-30T10:20:34Z
--XbCY
Content-Disposition: form-data; name="SenderID"
PayerB
--XbCY
Content-Disposition: form-data; name="ReceiverID"
HospitalA
--XbCY
Content-Disposition: form-data; name="CORERuleVersion"
2.2.0
--XbCY
Content-Disposition: form-data; name="ErrorCode"
Success
--XbCY
Content-Disposition: form-data; name="ErrorMessage"
None
--XbCY--