EDI 141 Product Service Claim Response

Functional Group WA

X12M Supply Chain Subcommittee

This Draft Standard for Trial Use contains the format and establishes the data contents of the Product Service Claim Response Transaction Set (141) for use within the context of an Electronic Data Interchange (EDI) environment. The transaction set can be used to transmit the status of a product service claim and the items accepted and rejected for payment from the product service claim. Each product service claim submission could have represented the repair of several individual products and each pair could have consisted of several repair actions involving parts and labor.

Heading

1. 010 · ST · Transaction Set Header · Max 1 · Mandatory

   To indicate the start of a transaction set and to assign a control number

2. 020 · BGN · Beginning Segment · Max 1 · Mandatory

   To indicate the beginning of a transaction set.

   The BGN segment must contain a number for reference to this claim response transaction and the date on which the transaction was created.

3. 030 · QTY · Quantity · Max 3 · Optional

   To specify quantity information.

   The QTY segment can be used to specify the total quantity of claims included in this transaction as well as the quantity approved and the quantity disapproved.

4. 035 · N9 · Reference Number · Max >1 · Optional

   To transmit identifying numbers and descriptive information as specified by the reference number qualifier

5. N1 Loop Mandatory Repeat 2

   1. 040 · N1 · Name · Max 1 · Mandatory

      To identify a party by type of organization, name and code

      The N1 loop defines the party making the product service claim response and the party to receive the response.

   2. 050 · N2 · Additional Name Information · Max 2 · Optional

      To specify additional names or those longer than 35 characters in length

   3. 060 · N3 · Address Information · Max 4 · Optional

      To specify the location of the named party

   4. 070 · N4 · Geographic Location · Max 1 · Optional

      To specify the geographic place of the named party

   5. 080 · REF · Reference Numbers · Max 2 · Optional

      To specify identifying numbers.

   6. 090 · PER · Administrative Communications Contact · Max 2 · Optional

      To identify a person or office to whom administrative communications should be directed

Detail

1. LX Loop Mandatory Repeat >1

   1. 010 · LX · Assigned Number · Max 1 · Mandatory

      To reference a line number in a transaction set.

      The LX loop serves only to separate the individual product service claim response levels. Consequently, the LX segment would probably contain only a sequential number.

   2. 015 · REF · Reference Numbers · Max 8 · Mandatory

      To specify identifying numbers.

      See the Figures Appendix for an explanation of the use of the REF segment in the LX loop.

   3. 020 · PCS · Product Claim Status · Max 1 · Optional

      To convey the status of a product service claim or claims or to supply adjustment reason codes and amounts as needed for an entire claim or for a particular item within the claim

      The PCS segment identifies the status of the item specified by the repeated REF segments.

   4. 030 · DTM · Date/Time Reference · Max >1 · Optional

      To specify pertinent dates and times

      The DTM segment clearly is an optional segment that tells any date or time information that is significant to that particular claim status level. It can be repeated, if necessary.

   5. 040 · MSG · Message Text · Max >1 · Optional

      To provide a free form format that would allow the transmission of text information.

      The MSG segment seldom should be used. It is only necessary if the coded warranty claim status in the PCS segment is not sufficient to describe the detail as to a change in a submitted claims. It can be repeated to allow a full length message. However, the use of the MSG segment inhibits computer processing of the transaction by either party.

   6. 050 · AMT · Monetary Amount · Max 1 · Optional

      To indicate the total monetary amount.

      The optional AMT segment would be used if the amount of the individual claim that will be credited or submitted needs to be specified. AMT02 contains the net sum of all individual items in this reference claim.

Summary

1. TDS Loop Optional Repeat 1

   1. 010 · TDS · Total Monetary Value Summary · Max 1 · Mandatory

      To specify the total invoice discounts and amounts

      TDS01 in the trailer is able to contain the total amount to be credited or paid on the sum of all claims contained in this response transaction.

   2. 020 · CUR · Currency · Max 1 · Optional

      To specify the currency (dollars, pounds, francs, etc.) used in a transaction

      The CUR segment will be used only if it is necessary to convert from one currency to another to pay for these claims.

2. 030 · SE · Transaction Set Trailer · Max 1 · Mandatory

   To indicate the end of the transaction set and provide the count of the transmitted segments (including the beginning (ST) and ending (SE) segments).

Figures Appendix

The REF segment is used to identify the item of the claim that is being specified in the following PCS segment. As shown in the Product Service Claim transaction set (TS 142) organization, there are a maximum of eight levels in a claim that completely identify an item required to be identified in the Product Claim Status segment. Shown as they appear in the Product Service Claim transaction (TS 142) with the data element 128 code values shown in the first column, they are:

TN transaction               BGN02

D9 claim                             N902

P7 product                                LX01

1X complaint                                    PRR01

1Y repair action                                     REP01

1Z financial detail                                         IT101

20 repair parts                                                   N902

22 special charge or allowance                                          ITA14

Thus, up to eight REF segments in the LX loop would be used to identify these eight levels. For ease in data processing and for human interpretation, they should be used in sequence. However, they are only to be used to the depth being described. For example, if there had been more than one product (item) in one claim and the claim for one of these products had been totally approved or disapproved, it would be necessary to use the first three levels. This would show the original claim transaction, the identity of the claim within that transaction, and the individual product. Data element 127 would contain the values associated with the appropriate code in data element 128.

The original claim was identified in the Product Service Claim Transaction Set (142) in the N9 Reference Number Segment (N902) immediately following the LX segment in table 2. The claim would appear in the second occurrence of the REF segment within the LX loop REF segment in this 141 Product Service Claim Response Transaction Set (141).

A root cause may be part of the complaint (problem report) in the Product Service Claim Transaction Set (142). It would have been shown in the Root Cause (RC) segment in the Problem Report (PRR) loop. A problem identified by a root cause may be eligible only for a standard claim allowance. The level within the Product Service Claim Response Transaction Set (141) would be shown by the fourth level complaint.