Claim Reversal Message Structure

The Claim Reversal Request will be structured as a Bundle, with a Message Header and the focus will be a Parameters IN resource. There is a single Bundle and Message Header profile that is used for all messaging in this PCS specification.

This transaction can be directly mapped to the existing CPHA Reversal transaction although it has been streamlined to include only the required data elements. The claim status will be updated to cancelled on a FHIR server when the reversal is successful.

FHIR Message Structure

The follow diagram depicts the high level structure, showing all resources that are included in the message and how they are linked together.

Profile Summary

The request will be structured with a standard Bundle and Message Header Request with a focus being the Parameters IN resource. The MessageHeader.EventCode will identify that this is a claim reversal request.

Profile Name	Profile Link
Bundle	Bundle Profile
MessageHeaderRequest	Profile for MessageHeaderRequest
Parameters IN	Reveral Parameters:IN