271 Premium Grace Period Notification

271 Premium Grace Period Notification: Industry Usage Instructions

271 Premium Grace Period Notification (HIPAA 007030X344) industry usage instructions describe when loops, segments, and elements are to be sent when complying with the transaction implementation guides. The three choices for usage are required, not used, and situational. To avoid confusion, these are named differently than the X12 standard Condition Designators (mandatory, optional, and relational).

Required

  • This loop/segment/element must always be sent.
  • Required segments in Situational loops only occur when the loop is used.
  • Required elements in Situational segments only occur when the segment is used.
  • Required component elements in Situational composite elements only occur when the composite element is used.

Not Used

  • This element must never be sent.

Situational

  • Use of this loop/segment/element varies, depending on data content and business context as described in the defining rule.
  • The defining rule is documented in a Situational Rule attached to the item.
  • There are two forms of Situational Rules:
    • The first form is “Required when <explicit condition statement>. If not required by this implementation guide, may be provided at the sender’s discretion, but cannot be required by the receiver.” The data qualified by such a situational rule cannot be required or requested by the receiver, transmission of this data is solely at the sender’s discretion.
    • The alternative form is “Required when <explicit condition statement>. If not required by this implementation guide, do not send.” The data qualified by such a situational rule cannot be sent except as described in the explicit condition statement.

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