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  1. Preface
  2. Libraries for Industry Standards
  3. Using Libraries
  4. Descriptions of the Libraries
  5. Generate Library Objects

Libraries Guide

Libraries Guide

HIPAA Message Structure

HIPAA Message Structure

The following excerpt illustrates a HIPAA message. The example is a Benefit Enrollment and Maintenance transaction, used by an insurance sponsor to provide benefit enrollment information to payers.
ISA*00**00**ZZ*EDI0021*ZZ*54828*032403*1253*U*00405*000000905*1*T*: GS*BE*EDI0021*54828*20030324*1253*5*X*004050X125~ ST*834*26608~ BGN*00*26608*20021226*1200*ES*2~ N1*P5*UES CORP*FI*111222333~ N1*IN*UNITED HEALTHCARE*FI*777888999~ INS*Y*18*021*28*A***FT~ REF*0F*851027461~ REF*1L*199301~ DTP*356*D8*20021219~ NM1*IL*1*CANOE*NANCY*A*MRS.*I*99*99999999~ PER*IP**HP*4104038790*WP*4104035500*EX*5684~ N3*9999 ROSE VILLAGE*FIRST FLOOR~ N4*FLOWERS*ND*999995*CY*WHEELING~ DMG*D8*19740801*F*M~ HD*021**PPO*PLAN COVERAGE DESCRIPTION*ESP~ DTP*348*D8*20021219~ SE*16*26608~ ST*834*26608~ BGN*00*26608*20021226*1200*ES*2~ N1*P5*UES CORP*FI*111222333~ N1*IN*UNITED HEALTHCARE*FI*777888999~ INS*N*01*021*28*A***FT~ REF*0F*948047150~ REF*1L*199301~
HIPAA messages consist of multiple segments. Each segment begins with an identifying code. The following table describes a few examples of the identifying codes contained in the sample message:
Identifying Code
Segment Description
ISA
Interchange Control header
GS
Functional Group Header segment
ST
Header segment
BGN
Beginning segment
N1
Name
SE
Trailer segment

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