PAAppealRequest Elements
1 min
element code comments request mandatory pacaseid mandatory pbm/payer assigned identifier for the pa that is being appealed appealcaseid conditional only returned in an paappealresponse if there are additional questions if returned by pbm/payer, provider vendors should include in subsequent paappealrequest messages deadlineforreply conditional if the pbm/payer returns a question set in their paappealresponse, the subsequent paappealrequest must be returned by this date/time questionset conditional if the pbm/payer returns a question set in their paappealresponse, the subsequent paappealrequest would contain the question set and associated answers panote conditional free text note describing reason for the appeal note some pbm/payers may approve or deny appeal requests solely based on panote if this field is not included in the first paappealrequest, some pbm/payers may deny the appeal