MEDRUCMedical 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.

  • UNH
    M必须(Mandatory)
    Repeat 1

    To head, identify and specify a message.

  • BGM
    BEGINNING OF MESSAGE
    M必须(Mandatory)
    Repeat 1

    To indicate the type and function of a message and to transmit the identifying number.

  • DTM
    DATE/TIME/PERIOD
    O可选(Optional)
    Repeat 9

    To specify date, and/or time, or period.

  • RFF
    REFERENCE
    O可选(Optional)
    Repeat 9

    To specify a reference.

  • FTX
    FREE TEXT
    O可选(Optional)
    Repeat 9

    To provide free form or coded text information.

  • CUX
    CURRENCIES
    O可选(Optional)
    Repeat 1

    To specify currencies used in the transaction and relevant details for the rate of exchange.

  • CNT
    CONTROL TOTAL
    O可选(Optional)
    Repeat 9

    To provide control total.

  • MOALoop1MONETARY AMOUNT LOOPO可选(Optional)Repeat 9
    MOATAX
    • MOA
      MONETARY AMOUNT
      M必须(Mandatory)
      Repeat 1

      To specify a monetary amount.

    • TAX
      DUTY/TAX/FEE DETAILS
      O可选(Optional)
      Repeat 1

      To specify relevant duty/tax/fee information.

  • PNALoop1PARTY IDENTIFICATION LOOPO可选(Optional)Repeat 999
    PNASEQADRCTACOMRFFRELNATLANSPREMPQUADTMSTSRCSPDIFII
    • PNA
      PARTY IDENTIFICATION
      M必须(Mandatory)
      Repeat 1

      To specify information necessary to establish the identity of a party.

    • SEQ
      SEQUENCE DETAILS
      O可选(Optional)
      Repeat 1

      To provide details relating to the sequence.

    • ADR
      ADDRESS
      O可选(Optional)
      Repeat 9

      To specify an address.

    • CTA
      CONTACT INFORMATION
      O可选(Optional)
      Repeat 9

      To identify a person or a department to whom communication should be directed.

    • COM
      COMMUNICATION CONTACT
      O可选(Optional)
      Repeat 9

      To identify a communication number of a department or a person to whom communication should be directed.

    • RFF
      REFERENCE
      O可选(Optional)
      Repeat 99

      To specify a reference.

    • REL
      RELATIONSHIP
      O可选(Optional)
      Repeat 9

      To identify relationships between objects.

    • NAT
      NATIONALITY
      O可选(Optional)
      Repeat 9

      To specify a nationality.

    • LAN
      LANGUAGE
      O可选(Optional)
      Repeat 9

      To specify a language.

    • SPR
      ORGANISATION CLASSIFICATION DETAILS
      O可选(Optional)
      Repeat 1

      To provide classification details relating to the activities of an organisation.

    • EMP
      EMPLOYMENT DETAILS
      O可选(Optional)
      Repeat 9

      To specify employment details.

    • QUA
      QUALIFICATION
      O可选(Optional)
      Repeat 9

      To specify the qualification of a person.

    • DTM
      DATE/TIME/PERIOD
      O可选(Optional)
      Repeat 99

      To specify date, and/or time, or period.

    • STS
      STATUS
      O可选(Optional)
      Repeat 1

      To specify the status of an object or service, including its category and the reason(s) for the status.

    • RCS
      REQUIREMENTS AND CONDITIONS
      O可选(Optional)
      Repeat 99

      To specify sector/subject requirements and conditions.

    • PDI
      PERSON DEMOGRAPHIC INFORMATION
      O可选(Optional)
      Repeat 1

      To specify items of person demographic information.

    • FII
      FINANCIAL INSTITUTION INFORMATION
      O可选(Optional)
      Repeat 9

      To identify an account and a related financial institution.

  • AGRLoop1AGREEMENT IDENTIFICATION LOOPO可选(Optional)Repeat 999
    AGRSEQRFFDTMICDLoop1
    • AGR
      AGREEMENT IDENTIFICATION
      M必须(Mandatory)
      Repeat 1

      To specify the agreement details.

    • SEQ
      SEQUENCE DETAILS
      O可选(Optional)
      Repeat 1

      To provide details relating to the sequence.

    • RFF
      REFERENCE
      O可选(Optional)
      Repeat 99

      To specify a reference.

    • DTM
      DATE/TIME/PERIOD
      O可选(Optional)
      Repeat 99

      To specify date, and/or time, or period.

    • ICDLoop1INSURANCE COVER DESCRIPTION LOOPO可选(Optional)Repeat 99
      ICDFTX
      • ICD
        INSURANCE COVER DESCRIPTION
        M必须(Mandatory)
        Repeat 1

        To describe the insurance cover.

      • FTX
        FREE TEXT
        O可选(Optional)
        Repeat 9

        To provide free form or coded text information.

  • DOCLoop1DOCUMENT/MESSAGE DETAILS LOOPO可选(Optional)Repeat 99
    DOCDTMPNALoop2
    • DOC
      DOCUMENT/MESSAGE DETAILS
      M必须(Mandatory)
      Repeat 1

      To identify documents and details directly related to it.

    • DTM
      DATE/TIME/PERIOD
      O可选(Optional)
      Repeat 9

      To specify date, and/or time, or period.

    • PNALoop2PARTY IDENTIFICATION LOOPO可选(Optional)Repeat 9
      PNAADRSTSRCS
      • PNA
        PARTY IDENTIFICATION
        M必须(Mandatory)
        Repeat 1

        To specify information necessary to establish the identity of a party.

      • ADR
        ADDRESS
        O可选(Optional)
        Repeat 9

        To specify an address.

      • STS
        STATUS
        O可选(Optional)
        Repeat 1

        To specify the status of an object or service, including its category and the reason(s) for the status.

      • RCS
        REQUIREMENTS AND CONDITIONS
        O可选(Optional)
        Repeat 9

        To specify sector/subject requirements and conditions.

  • FCALoop1FINANCIAL CHARGES ALLOCATION LOOPO可选(Optional)Repeat 999
    FCAGEIRFFDTMFTXAGRDOCMOALoop2RCSLoop1PNALoop3PRCLoop1
    • FCA
      FINANCIAL CHARGES ALLOCATION
      M必须(Mandatory)
      Repeat 1

      Description of allocation of charges.

    • GEI
      PROCESSING INFORMATION
      O可选(Optional)
      Repeat 9

      To identify processing information.

    • RFF
      REFERENCE
      O可选(Optional)
      Repeat 99

      To specify a reference.

    • DTM
      DATE/TIME/PERIOD
      O可选(Optional)
      Repeat 99

      To specify date, and/or time, or period.

    • FTX
      FREE TEXT
      O可选(Optional)
      Repeat 99

      To provide free form or coded text information.

    • AGR
      AGREEMENT IDENTIFICATION
      O可选(Optional)
      Repeat 99

      To specify the agreement details.

    • DOC
      DOCUMENT/MESSAGE DETAILS
      O可选(Optional)
      Repeat 9

      To identify documents and details directly related to it.

    • MOALoop2MONETARY AMOUNT LOOPO可选(Optional)Repeat 99
      MOATAX
      • MOA
        MONETARY AMOUNT
        M必须(Mandatory)
        Repeat 1

        To specify a monetary amount.

      • TAX
        DUTY/TAX/FEE DETAILS
        O可选(Optional)
        Repeat 1

        To specify relevant duty/tax/fee information.

    • RCSLoop1REQUIREMENTS AND CONDITIONS LOOPO可选(Optional)Repeat 99
      RCSFTX
      • RCS
        REQUIREMENTS AND CONDITIONS
        M必须(Mandatory)
        Repeat 1

        To specify sector/subject requirements and conditions.

      • FTX
        FREE TEXT
        O可选(Optional)
        Repeat 9

        To provide free form or coded text information.

    • PNALoop3PARTY IDENTIFICATION LOOPO可选(Optional)Repeat 999
      PNARFFADRCOMDTMPDIRSLNATLANHANREL
      • PNA
        PARTY IDENTIFICATION
        M必须(Mandatory)
        Repeat 1

        To specify information necessary to establish the identity of a party.

      • RFF
        REFERENCE
        O可选(Optional)
        Repeat 99

        To specify a reference.

      • ADR
        ADDRESS
        O可选(Optional)
        Repeat 9

        To specify an address.

      • COM
        COMMUNICATION CONTACT
        O可选(Optional)
        Repeat 9

        To identify a communication number of a department or a person to whom communication should be directed.

      • DTM
        DATE/TIME/PERIOD
        O可选(Optional)
        Repeat 99

        To specify date, and/or time, or period.

      • PDI
        PERSON DEMOGRAPHIC INFORMATION
        O可选(Optional)
        Repeat 1

        To specify items of person demographic information.

      • RSL
        RESULT
        O可选(Optional)
        Repeat 9

        To specify a discrete or non-discrete result as a value or value range.

      • NAT
        NATIONALITY
        O可选(Optional)
        Repeat 9

        To specify a nationality.

      • LAN
        LANGUAGE
        O可选(Optional)
        Repeat 9

        To specify a language.

      • HAN
        HANDLING INSTRUCTIONS
        O可选(Optional)
        Repeat 9

        To specify handling and where necessary, notify hazards.

      • REL
        RELATIONSHIP
        O可选(Optional)
        Repeat 1

        To identify relationships between objects.

    • PRCLoop1PROCESS IDENTIFICATION LOOPO可选(Optional)Repeat 999
      PRCGEISTSIMDCINPNADTMRFFFTXQTYPCDPASLoop1MOALoop3RCSLoop2CLILoop1
      • PRC
        PROCESS IDENTIFICATION
        M必须(Mandatory)
        Repeat 1

        To identify a process.

      • GEI
        PROCESSING INFORMATION
        O可选(Optional)
        Repeat 1

        To identify processing information.

      • STS
        STATUS
        O可选(Optional)
        Repeat 9

        To specify the status of an object or service, including its category and the reason(s) for the status.

      • IMD
        ITEM DESCRIPTION
        O可选(Optional)
        Repeat 9

        To describe an item in either an industry or free format.

      • CIN
        CLINICAL INFORMATION
        O可选(Optional)
        Repeat 99

        To describe an item of clinical information.

      • PNA
        PARTY IDENTIFICATION
        O可选(Optional)
        Repeat 99

        To specify information necessary to establish the identity of a party.

      • DTM
        DATE/TIME/PERIOD
        O可选(Optional)
        Repeat 99

        To specify date, and/or time, or period.

      • RFF
        REFERENCE
        O可选(Optional)
        Repeat 99

        To specify a reference.

      • FTX
        FREE TEXT
        O可选(Optional)
        Repeat 99

        To provide free form or coded text information.

      • QTY
        QUANTITY
        O可选(Optional)
        Repeat 99

        To specify a pertinent quantity.

      • PCD
        PERCENTAGE DETAILS
        O可选(Optional)
        Repeat 99

        To specify percentage information.

      • PASLoop1ATTENDANCE LOOPO可选(Optional)Repeat 99
        PASLOCDTMRFF
        • PAS
          ATTENDANCE
          M必须(Mandatory)
          Repeat 1

          To specify attendance information relating to an individual.

        • LOC
          PLACE/LOCATION IDENTIFICATION
          O可选(Optional)
          Repeat 9

          To identify a place or a location and/or related locations.

        • DTM
          DATE/TIME/PERIOD
          O可选(Optional)
          Repeat 9

          To specify date, and/or time, or period.

        • RFF
          REFERENCE
          O可选(Optional)
          Repeat 9

          To specify a reference.

      • MOALoop3MONETARY AMOUNT LOOPO可选(Optional)Repeat 99
        MOATAX
        • MOA
          MONETARY AMOUNT
          M必须(Mandatory)
          Repeat 1

          To specify a monetary amount.

        • TAX
          DUTY/TAX/FEE DETAILS
          O可选(Optional)
          Repeat 1

          To specify relevant duty/tax/fee information.

      • RCSLoop2REQUIREMENTS AND CONDITIONS LOOPO可选(Optional)Repeat 99
        RCSFTX
        • RCS
          REQUIREMENTS AND CONDITIONS
          M必须(Mandatory)
          Repeat 1

          To specify sector/subject requirements and conditions.

        • FTX
          FREE TEXT
          O可选(Optional)
          Repeat 9

          To provide free form or coded text information.

      • CLILoop1CLINICAL INTERVENTION LOOPO可选(Optional)Repeat 999
        CLIGEIIMDCINPNADTMRFFFTXQTYPCDPACMOALoop4RCSLoop3EQDLoop1
        • CLI
          CLINICAL INTERVENTION
          M必须(Mandatory)
          Repeat 1

          To specify a clinical intervention such as treatments and investigations.

        • GEI
          PROCESSING INFORMATION
          O可选(Optional)
          Repeat 1

          To identify processing information.

        • IMD
          ITEM DESCRIPTION
          O可选(Optional)
          Repeat 9

          To describe an item in either an industry or free format.

        • CIN
          CLINICAL INFORMATION
          O可选(Optional)
          Repeat 99

          To describe an item of clinical information.

        • PNA
          PARTY IDENTIFICATION
          O可选(Optional)
          Repeat 99

          To specify information necessary to establish the identity of a party.

        • DTM
          DATE/TIME/PERIOD
          O可选(Optional)
          Repeat 99

          To specify date, and/or time, or period.

        • RFF
          REFERENCE
          O可选(Optional)
          Repeat 99

          To specify a reference.

        • FTX
          FREE TEXT
          O可选(Optional)
          Repeat 99

          To provide free form or coded text information.

        • QTY
          QUANTITY
          O可选(Optional)
          Repeat 99

          To specify a pertinent quantity.

        • PCD
          PERCENTAGE DETAILS
          O可选(Optional)
          Repeat 99

          To specify percentage information.

        • PAC
          PACKAGE
          O可选(Optional)
          Repeat 9

          To describe the number and type of packages/physical units.

        • MOALoop4MONETARY AMOUNT LOOPO可选(Optional)Repeat 99
          MOATAX
          • MOA
            MONETARY AMOUNT
            M必须(Mandatory)
            Repeat 1

            To specify a monetary amount.

          • TAX
            DUTY/TAX/FEE DETAILS
            O可选(Optional)
            Repeat 1

            To specify relevant duty/tax/fee information.

        • RCSLoop3REQUIREMENTS AND CONDITIONS LOOPO可选(Optional)Repeat 99
          RCSFTX
          • RCS
            REQUIREMENTS AND CONDITIONS
            M必须(Mandatory)
            Repeat 1

            To specify sector/subject requirements and conditions.

          • FTX
            FREE TEXT
            O可选(Optional)
            Repeat 9

            To provide free form or coded text information.

        • EQDLoop1EQUIPMENT DETAILS LOOPO可选(Optional)Repeat 99
          EQDSEQ
          • EQD
            EQUIPMENT DETAILS
            M必须(Mandatory)
            Repeat 1

            To identify a unit of equipment.

          • SEQ
            SEQUENCE DETAILS
            O可选(Optional)
            Repeat 1

            To provide details relating to the sequence.

  • TMDLoop1TRANSPORT MOVEMENT DETAILS LOOPO可选(Optional)Repeat 999
    TMDSEQGEIFTXTDTLoop1
    • TMD
      TRANSPORT MOVEMENT DETAILS
      M必须(Mandatory)
      Repeat 1

      To specify operational transport movement details for a goods item or equipment (which may differ from the contractual conditions).

    • SEQ
      SEQUENCE DETAILS
      O可选(Optional)
      Repeat 1

      To provide details relating to the sequence.

    • GEI
      PROCESSING INFORMATION
      O可选(Optional)
      Repeat 1

      To identify processing information.

    • FTX
      FREE TEXT
      O可选(Optional)
      Repeat 99

      To provide free form or coded text information.

    • TDTLoop1TRANSPORT INFORMATION LOOPO可选(Optional)Repeat 999
      TDTGEIIMDPNARFFFTXCINQTYADRLoop1TSRLoop1TCCLoop1
      • TDT
        TRANSPORT INFORMATION
        M必须(Mandatory)
        Repeat 1

        To specify information regarding the transport such as mode of transport, means of transport, its conveyance reference number and the identification of the means of transport.

      • GEI
        PROCESSING INFORMATION
        O可选(Optional)
        Repeat 1

        To identify processing information.

      • IMD
        ITEM DESCRIPTION
        O可选(Optional)
        Repeat 9

        To describe an item in either an industry or free format.

      • PNA
        PARTY IDENTIFICATION
        O可选(Optional)
        Repeat 99

        To specify information necessary to establish the identity of a party.

      • RFF
        REFERENCE
        O可选(Optional)
        Repeat 99

        To specify a reference.

      • FTX
        FREE TEXT
        O可选(Optional)
        Repeat 99

        To provide free form or coded text information.

      • CIN
        CLINICAL INFORMATION
        O可选(Optional)
        Repeat 99

        To describe an item of clinical information.

      • QTY
        QUANTITY
        O可选(Optional)
        Repeat 99

        To specify a pertinent quantity.

      • ADRLoop1ADDRESS LOOPO可选(Optional)Repeat 99
        ADRDTM
        • ADR
          ADDRESS
          M必须(Mandatory)
          Repeat 1

          To specify an address.

        • DTM
          DATE/TIME/PERIOD
          O可选(Optional)
          Repeat 9

          To specify date, and/or time, or period.

      • TSRLoop1TRANSPORT SERVICE REQUIREMENTS LOOPO可选(Optional)Repeat 99
        TSRFTX
        • TSR
          TRANSPORT SERVICE REQUIREMENTS
          M必须(Mandatory)
          Repeat 1

          To specify the contract and carriage conditions and service and priority requirements for the transport.

        • FTX
          FREE TEXT
          O可选(Optional)
          Repeat 9

          To provide free form or coded text information.

      • TCCLoop1CHARGE/RATE CALCULATIONS LOOPO可选(Optional)Repeat 999
        TCCGEIIMDDTMRFFFTXQTYPCDMOALoop5TSRLoop2
        • TCC
          CHARGE/RATE CALCULATIONS
          M必须(Mandatory)
          Repeat 1

          To specify charges.

        • GEI
          PROCESSING INFORMATION
          O可选(Optional)
          Repeat 1

          To identify processing information.

        • IMD
          ITEM DESCRIPTION
          O可选(Optional)
          Repeat 9

          To describe an item in either an industry or free format.

        • DTM
          DATE/TIME/PERIOD
          O可选(Optional)
          Repeat 99

          To specify date, and/or time, or period.

        • RFF
          REFERENCE
          O可选(Optional)
          Repeat 99

          To specify a reference.

        • FTX
          FREE TEXT
          O可选(Optional)
          Repeat 99

          To provide free form or coded text information.

        • QTY
          QUANTITY
          O可选(Optional)
          Repeat 99

          To specify a pertinent quantity.

        • PCD
          PERCENTAGE DETAILS
          O可选(Optional)
          Repeat 99

          To specify percentage information.

        • MOALoop5MONETARY AMOUNT LOOPO可选(Optional)Repeat 99
          MOATAX
          • MOA
            MONETARY AMOUNT
            M必须(Mandatory)
            Repeat 1

            To specify a monetary amount.

          • TAX
            DUTY/TAX/FEE DETAILS
            O可选(Optional)
            Repeat 1

            To specify relevant duty/tax/fee information.

        • TSRLoop2TRANSPORT SERVICE REQUIREMENTS LOOPO可选(Optional)Repeat 99
          TSRFTX
          • TSR
            TRANSPORT SERVICE REQUIREMENTS
            M必须(Mandatory)
            Repeat 1

            To specify the contract and carriage conditions and service and priority requirements for the transport.

          • FTX
            FREE TEXT
            O可选(Optional)
            Repeat 9

            To provide free form or coded text information.

  • AUTLoop1AUTHENTICATION RESULT LOOPO可选(Optional)Repeat 9
    AUTDTM
    • AUT
      AUTHENTICATION RESULT
      M必须(Mandatory)
      Repeat 1

      To specify results of the application of an authentication procedure.

    • DTM
      DATE/TIME/PERIOD
      O可选(Optional)
      Repeat 9

      To specify date, and/or time, or period.

  • UNT
    M必须(Mandatory)
    Repeat 1

    To end and check the completeness of a message.

Segment
EDIFACT EDI Release D15A
To head, identify and specify a message.
Elements
  • UNH010062MESSAGE REFERENCE NUMBER
    AN
    M必须(Mandatory)
    Min 0 / Max 14

    Unique message reference assigned by the sender.

  • UNH02S009MESSAGE IDENTIFIERM必须(Mandatory)
    0065005200540051005701100113
    • UNH02010065Message type
      ID
      M必须(Mandatory)
      Min 0 / Max 6

      Code identifying a type of message and assigned by its controlling agency.

      Codes (212)
    • UNH02020052Message version number
      ID
      M必须(Mandatory)
      Min 0 / Max 3

      Version number of a message type.

      Codes (8)
    • UNH02030054Message release number
      ID
      M必须(Mandatory)
      Min 0 / Max 3

      Release number within the current message version number.

      Codes (55)
    • UNH02040051Controlling agency, coded
      ID
      M必须(Mandatory)
      Min 0 / Max 3

      Code identifying a controlling agency.

      Codes (26)
    • UNH02050057Association assigned code
      AN
      O可选(Optional)
      Min 0 / Max 6

      Code, assigned by the association responsible for the design and maintenance of the message type concerned, which further identifies the message.

    • UNH02060110Code list directory version number
      AN
      O可选(Optional)
      Min 0 / Max 6

      Version number of the code list directory.

    • UNH02070113Message type sub-function identification
      ID
      O可选(Optional)
      Min 0 / Max 6

      Code identifying a sub-function of a message type.

      Codes (21)
  • UNH030068COMMON ACCESS REFERENCE
    AN
    O可选(Optional)
    Min 0 / Max 35

    Reference serving as a key to relate all subsequent transfers of data to the same business case or file.

  • UNH04S010STATUS OF THE TRANSFERO可选(Optional)
    00700073
    • UNH04010070Sequence of transfers
      N
      M必须(Mandatory)
      Min 0 / Max 2

      Number assigned by the sender indicating the transfer sequence of a message related to the same topic. The message could be an addition or a change to an earlier transfer related to the same topic.

    • UNH04020073First and last transfer
      ID
      O可选(Optional)
      Min 1 / Max 1

      Indication used for the first and last message in a sequence of messages related to the same topic.

      Codes (2)
  • UNH05S016MESSAGE SUBSET IDENTIFICATIONO可选(Optional)
    0115011601180051
    • UNH05010115Message subset identification
      AN
      M必须(Mandatory)
      Min 0 / Max 14

      Coded identification of a message subset, assigned by its controlling agency.

    • UNH05020116Message subset version number
      AN
      O可选(Optional)
      Min 0 / Max 3

      Version number of the message subset.

    • UNH05030118Message subset release number
      AN
      O可选(Optional)
      Min 0 / Max 3

      Release number within the message subset version number.

    • UNH05040051Controlling agency, coded
      ID
      O可选(Optional)
      Min 0 / Max 3

      Code identifying a controlling agency.

      Codes (26)
  • UNH06S017MESSAGE IMPLEMENTATION GUIDELINE IDENTIFICATIONO可选(Optional)
    0121012201240051
    • UNH06010121Message implementation guideline identification
      AN
      M必须(Mandatory)
      Min 0 / Max 14

      Coded identification of the message implementation guideline, assigned by its controlling agency.

    • UNH06020122Message implementation guideline version number
      AN
      O可选(Optional)
      Min 0 / Max 3

      Version number of the message implementation guideline.

    • UNH06030124Message implementation guideline release number
      AN
      O可选(Optional)
      Min 0 / Max 3

      Release number within the message implementation guideline version number.

    • UNH06040051Controlling agency, coded
      ID
      O可选(Optional)
      Min 0 / Max 3

      Code identifying a controlling agency.

      Codes (26)
  • UNH07S018SCENARIO IDENTIFICATIONO可选(Optional)
    0127012801300051
    • UNH07010127Scenario identification
      AN
      M必须(Mandatory)
      Min 0 / Max 14

      Code identifying scenario.

    • UNH07020128Scenario version number
      AN
      O可选(Optional)
      Min 0 / Max 3

      Version number of a scenario.

    • UNH07030130Scenario release number
      AN
      O可选(Optional)
      Min 0 / Max 3

      Release number within the scenario version number.

    • UNH07040051Controlling agency, coded
      ID
      O可选(Optional)
      Min 0 / Max 3

      Code identifying a controlling agency.

      Codes (26)