The architecture for all messages in this standard are defined herein. The Record Types used in all messages formatted in accordance with this standard can be found in Part 2 of the Claim Detail Message Suite Standard.
These Record Types are used in Profile-specific standards which are, in turn, built upon this standard. At the time of writing this Part, the following Profiles have been defined by DDEX as:
- Profile for Post-usage Reporting of New Claims and/or Invoice Details (Part 3);
- Profile for Correcting Post-usage Reports of New Claims and/or Invoice Details (Part 3);
- Profile for Pre-usage Reporting of New Claims (Part 3);
- Profile for Correcting Pre-usage Reports of New Claims (Part 3);
- Notification of Record Discrepancies (Part 4); and
- Notification of Over-Claim Discrepancies (Part 5).
DDEX expects to add further Profile standards over time. They will be published on the DDEX Knowledge Base where a complete list of Profiles of the Claim Detail Message Suite Standard can be found.