MEDRUC Medical resource usage and cost

The MEDRUC message is sent from a party providing medical and related administrative services to a funding institution, allowing evaluation of the medical activity and justification for reimbursement. It can also be sent from a funding institution to another party in order to advise which reimbursements have been made.

The MEDRUC message can carry either initial specifications of used resources and costs, or modifications to specifications given in a previous message.

Typically, the MEDRUC message can be used between a healthcare service provider or an insurance company and another insurance company as well as between an insurance company and a healthcare service provider.

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Header

Position

Segment

Name

Max use

0010Message headerMandatory->Max 1
To head, identify and specify a message.
0020Beginning of messageMandatory->Max 1
To indicate the type and function of a message and to transmit the identifying number.
0030Date/time/periodConditional->Max 9
To specify date, and/or time, or period.
0040ReferenceConditional->Max 9
To specify a reference.
0050Free textConditional->Max 9
To provide free form or coded text information.
0060Control totalConditional->Max 9
To provide control total.
Segment group 1
Repeat 9
1. 0080Monetary amountMandatory->Max 1
  To specify a monetary amount.
2. 0090Duty/tax/fee detailsConditional->Max 1
  To specify relevant duty/tax/fee information.
Segment group 2
Repeat 999
1. 0110Party identificationMandatory->Max 1
  To specify information necessary to establish the identity of a party.
2. 0120Sequence detailsConditional->Max 1
  To provide specific details related to the delivery sequence.
3. 0130AddressConditional->Max 9
  To specify an address.
4. 0140Contact informationConditional->Max 9
  To identify a person or a department to whom communication should be directed.
5. 0150Communication contactConditional->Max 9
  To identify a communication number of a department or a person to whom communication should be directed.
6. 0160ReferenceConditional->Max 99
  To specify a reference.
7. 0170LanguageConditional->Max 9
  To specify a language.
8. 0180Organisation classification detailsConditional->Max 1
  To provide classification details relating to the activities of an organisation.
9. 0190Employment detailsConditional->Max 9
  To specify employment details.
10. 0200QualificationConditional->Max 9
  To specify the qualification of a person.
11. 0210Date/time/periodConditional->Max 99
  To specify date, and/or time, or period.
12. 0220Requirements and conditionsConditional->Max 99
  To specify sector/subject requirements and conditions.
13. 0230Financial institution informationConditional->Max 9
  To identify an account and a related financial institution.
Segment group 3
Repeat 999
1. 0250Agreement identificationMandatory->Max 1
  To specify the agreement details.
2. 0260Sequence detailsConditional->Max 1
  To provide specific details related to the delivery sequence.
3. 0270ReferenceConditional->Max 99
  To specify a reference.
4. 0280Date/time/periodConditional->Max 99
  To specify date, and/or time, or period.
5. Segment group 4
  Repeat 99
  1. 0300Insurance cover descriptionMandatory->Max 1
    To describe the insurance cover.
  2. 0310Free textConditional->Max 9
    To provide free form or coded text information.
Segment group 5
Repeat 999
1. 0330Financial charges allocationMandatory->Max 1
  Description of allocation of charges.
2. 0340General indicatorConditional->Max 1
  To transmit a processing indicator.
3. 0350ReferenceConditional->Max 99
  To specify a reference.
4. 0360Date/time/periodConditional->Max 99
  To specify date, and/or time, or period.
5. 0370Free textConditional->Max 99
  To provide free form or coded text information.
6. 0380Agreement identificationConditional->Max 99
  To specify the agreement details.
7. Segment group 6
  Repeat 99
  1. 0400Requirements and conditionsMandatory->Max 1
    To specify sector/subject requirements and conditions.
  2. 0410Free textConditional->Max 9
    To provide free form or coded text information.
8. Segment group 7
  Repeat 999
  1. 0430Party identificationMandatory->Max 1
    To specify information necessary to establish the identity of a party.
  2. 0440ReferenceConditional->Max 99
    To specify a reference.
  3. 0450AddressConditional->Max 9
    To specify an address.
  4. 0460Communication contactConditional->Max 9
    To identify a communication number of a department or a person to whom communication should be directed.
  5. 0470Date/time/periodConditional->Max 99
    To specify date, and/or time, or period.
  6. 0480Person demographic informationConditional->Max 1
    To specify items of person demographic information.
  7. 0490NationalityConditional->Max 9
    To specify a nationality.
  8. 0500LanguageConditional->Max 9
    To specify a language.
  9. 0510Handling instructionsConditional->Max 9
    To specify handling and where necessary, notify hazards.
  10. 0520RelationshipConditional->Max 1
    To identify the direct relationship between the data/information contained in one segment and the data/information contained in one or more other segments.
9. Segment group 8
  Repeat 999
  1. 0540Process identificationMandatory->Max 1
    To identify a process.
  2. 0550General indicatorConditional->Max 1
    To transmit a processing indicator.
  3. 0560Item descriptionConditional->Max 9
    To describe an item in either an industry or free format.
  4. 0570Clinical informationConditional->Max 99
    To describe an item of clinical information.
  5. 0580Party identificationConditional->Max 99
    To specify information necessary to establish the identity of a party.
  6. 0590Date/time/periodConditional->Max 99
    To specify date, and/or time, or period.
  7. 0600ReferenceConditional->Max 99
    To specify a reference.
  8. 0610Free textConditional->Max 99
    To provide free form or coded text information.
  9. 0620QuantityConditional->Max 99
    To specify a pertinent quantity.
  10. 0630Percentage detailsConditional->Max 99
    To specify percentage information.
  11. Segment group 9
    Repeat 99
    0650AttendanceMandatory->Max 1
    To specify attendance information relating to an individual.
    0660Place/location identificationConditional->Max 9
    To identify a place or a location and/or related locations.
    0670Date/time/periodConditional->Max 9
    To specify date, and/or time, or period.
    0680ReferenceConditional->Max 9
    To specify a reference.
  12. Segment group 10
    Repeat 99
    0700Monetary amountMandatory->Max 1
    To specify a monetary amount.
    0710Duty/tax/fee detailsConditional->Max 1
    To specify relevant duty/tax/fee information.
  13. Segment group 11
    Repeat 99
    0730Requirements and conditionsMandatory->Max 1
    To specify sector/subject requirements and conditions.
    0740Free textConditional->Max 9
    To provide free form or coded text information.
  14. Segment group 12
    Repeat 999
    0760Clinical interventionMandatory->Max 1
    To specify a clinical intervention such as treatments and investigations.
    0770General indicatorConditional->Max 1
    To transmit a processing indicator.
    0780Item descriptionConditional->Max 9
    To describe an item in either an industry or free format.
    0790Clinical informationConditional->Max 99
    To describe an item of clinical information.
    0800Party identificationConditional->Max 99
    To specify information necessary to establish the identity of a party.
    0810Date/time/periodConditional->Max 99
    To specify date, and/or time, or period.
    0820ReferenceConditional->Max 99
    To specify a reference.
    0830Free textConditional->Max 99
    To provide free form or coded text information.
    0840QuantityConditional->Max 99
    To specify a pertinent quantity.
    0850Percentage detailsConditional->Max 99
    To specify percentage information.
    0860PackageConditional->Max 9
    To describe the number and type of packages/physical units.
    Segment group 13
    Repeat 99
    0880Monetary amountMandatory->Max 1
    To specify a monetary amount.
    0890Duty/tax/fee detailsConditional->Max 1
    To specify relevant duty/tax/fee information.
    Segment group 14
    Repeat 99
    0910Requirements and conditionsMandatory->Max 1
    To specify sector/subject requirements and conditions.
    0920Free textConditional->Max 9
    To provide free form or coded text information.
    Segment group 15
    Repeat 99
    0940Equipment detailsMandatory->Max 1
    To identify a unit of equipment.
    0950Sequence detailsConditional->Max 1
    To provide specific details related to the delivery sequence.
Segment group 16
Repeat 999
1. 0970Transport movement detailsMandatory->Max 1
  To specify operational transport movement details for a goods item or equipment (which may differ from the contractual conditions).
2. 0980Sequence detailsConditional->Max 1
  To provide specific details related to the delivery sequence.
3. 0990General indicatorConditional->Max 1
  To transmit a processing indicator.
4. 1000Free textConditional->Max 99
  To provide free form or coded text information.
5. Segment group 17
  Repeat 999
  1. 1020Details of transportMandatory->Max 1
    To specify the transport details such as mode of transport, means of transport, its conveyance reference number and the identification of the means of transport. The segment may be pointed to by the TPL segment.
  2. 1030General indicatorConditional->Max 1
    To transmit a processing indicator.
  3. 1040Item descriptionConditional->Max 9
    To describe an item in either an industry or free format.
  4. 1050Party identificationConditional->Max 99
    To specify information necessary to establish the identity of a party.
  5. 1060ReferenceConditional->Max 99
    To specify a reference.
  6. 1070Free textConditional->Max 99
    To provide free form or coded text information.
  7. 1080Clinical informationConditional->Max 99
    To describe an item of clinical information.
  8. 1090QuantityConditional->Max 99
    To specify a pertinent quantity.
  9. Segment group 18
    Repeat 99
    1110AddressMandatory->Max 1
    To specify an address.
    1120Date/time/periodConditional->Max 9
    To specify date, and/or time, or period.
  10. Segment group 19
    Repeat 99
    1140Transport service requirementsMandatory->Max 1
    To specify the contract and carriage conditions and service and priority requirements for the transport.
    1150Free textConditional->Max 9
    To provide free form or coded text information.
  11. Segment group 20
    Repeat 999
    1170Transport charge/rate calculationsMandatory->Max 1
    To specify charges.
    1180General indicatorConditional->Max 1
    To transmit a processing indicator.
    1190Item descriptionConditional->Max 9
    To describe an item in either an industry or free format.
    1200Date/time/periodConditional->Max 99
    To specify date, and/or time, or period.
    1210ReferenceConditional->Max 99
    To specify a reference.
    1220Free textConditional->Max 99
    To provide free form or coded text information.
    1230QuantityConditional->Max 99
    To specify a pertinent quantity.
    1240Percentage detailsConditional->Max 99
    To specify percentage information.
    Segment group 21
    Repeat 99
    1260Monetary amountMandatory->Max 1
    To specify a monetary amount.
    1270Duty/tax/fee detailsConditional->Max 1
    To specify relevant duty/tax/fee information.
    Segment group 22
    Repeat 99
    1290Transport service requirementsMandatory->Max 1
    To specify the contract and carriage conditions and service and priority requirements for the transport.
    1300Free textConditional->Max 9
    To provide free form or coded text information.
Segment group 23
Repeat 9
1. 1320Authentication resultMandatory->Max 1
  To specify results of the application of an authentification procedure.
2. 1330Date/time/periodConditional->Max 9
  To specify date, and/or time, or period.
1340Message trailerMandatory->Max 1
To end and check the completeness of a message.