The requirement to support a minimum of 64MB applies to the entire content of the BDS segment of the X12 v6020 275, not per loop. Please note, this requirement is only a floor, not a ceiling, meaning that organizations can choose to accept more than 64MB of data. Organizations must accept a minimum of 64MB.
Yes. Multiple attachments can be sent within a single X12 v6020 275.
No. If an entity’s internal document management system is not used for holding and processing attachments, it is not subject to the 64 MB minimum size requirement.
No. If the information is not available, it is not required.
No. The data does not need to conform to X12 data element naming conventions and as such, do not need to correspond to those X12 data elements as it is not an X12 transaction.
No. The CORE-required Minimum Data Elements regarding labels and descriptions indicate that the data could be originating within the provider’s system or the payer’s system. As such, if an Auth ID is not available when the attachment is sent, it is not required.
No. The list of data elements is recommended to assist with reassociation. The data elements should only be sent, if available, to the provider at the time of submissions. The lists of data elements in the rules are not prohibitive or exhaustive.
The common reference data lists represent commonly available data that, after several reviews, the Attachments Advisory Group and Attachments Subgroup participants (including providers, health plans, and vendors) ranked most useful in assisting document management systems with reassociation of an attachment to its original prior authorization request.