RF1 - Referral Information Segment

Attention: Retained for backwards compatibility as of V2.9. Refer to 7.4.4 for the PRT segment instead.

This segment represents information that may be useful when sending referrals from the referring provider to the referred-to provider.

HL7 Attribute Table - RF1 - Referral Information Segment

Seq#	Data Element Name	DataType	Usage	Vocabulary	Cardinality	Item #	Length	C.LEN	Flags
RF1
1	Referral Status	CWE	O	0283(S) Referral Status(Suggested)	[0..1]	01137
2	Referral Priority	CWE	O	0280 Referral Priority	[0..1]	01138
3	Referral Type	CWE	O	0281 Referral Type	[0..1]	01139
4	Referral Disposition	CWE	O	0282(S) Referral Disposition(Suggested)	[0..*]	01140
5	Referral Category	CWE	O	0284(S) Referral Category(Suggested)	[0..1]	01141
6	Originating Referral Identifier	EI	R		[1..1]	01142
7	Effective Date	DTM	O		[0..1]	01143
8	Expiration Date	DTM	O		[0..1]	01144
9	Process Date	DTM	O		[0..1]	01145
10	Referral Reason	CWE	O	0336(S) Referral Reason(Suggested)	[0..*]	01228
11	External Referral Identifier	EI	O		[0..*]	01300
12	Referral Documentation Completion Status	CWE	O	0865 Referral Documentation Completion Status	[0..1]	02262
13	Planned Treatment Stop Date	DTM	O		[0..1]	03400	[24..*]
14	Referral Reason Text	ST	O		[0..1]	03401	[60..*]
15	Number of Authorized Treatments/Units	CQ	O		[0..1]	03402	[721..*]
16	Number of Used Treatments/Units	CQ	O		[0..1]	03403	[721..*]
17	Number of Schedule Treatments/Units	CQ	O		[0..1]	03404	[721..*]
18	Remaining Benefit Amount	MO	O		[0..1]	03405	[20..*]
19	Authorized Provider	XON	O		[0..1]	03406	[250..*]
20	Authorized Health Professional	XCN	O		[0..1]	03407	[250..*]
21	Source Text	ST	O		[0..1]	03408	[60..*]
22	Source Date	DTM	O		[0..1]	03409	[24..*]
23	Source Phone	XTN	O		[0..1]	03410	[250..*]
24	Comment	ST	O		[0..1]	03411	[250..*]
25	Action Code	ID	O	0206(R) Segment Action Code(Required)	[0..1]	03412	[1..*]

RF1-1: Referral Status (CWE) 01137

Definition: This field contains the status of the referral as defined by either the referred-to or the referred-by provider. Refer to User-defined Table 0283 - Referral Status in Chapter 2C, Code Tables, for suggested values.

RF1-2: Referral Priority (CWE) 01138

Definition: This field contains the urgency of the referral. Refer to User-defined Table 0280 - Referral Priority in Chapter 2C, Code Tables, for suggested values.

RF1-3: Referral Type (CWE) 01139

Definition: This field contains the type of referral. It is loosely associated with a clinical specialty or type of resource. Refer to User-defined Table 0281 - Referral Type in Chapter 2C, Code Tables, for suggested values.

RF1-4: Referral Disposition (CWE) 01140

Definition: This field contains the type of response or action that the referring provider would like from the referred-to provider. Refer to User-defined Table 0282 - Referral Disposition for suggested values.

RF1-5: Referral Category (CWE) 01141

Definition: This field contains the location at which the referral will take place. Refer to User-defined Table 0284 - Referral Category for suggested values.

RF1-6: Originating Referral Identifier (EI) 01142

Definition: This field contains the originating application's permanent identifier for the referral. This is a composite field.

The first component is a string of up to 15 characters that identifies an individual referral. It is assigned by the originating application, and it identifies a referral, and the subsequent referral transactions, uniquely among all such referrals from a particular processing application.

The second component is optional because this field, itself, is already defined as a referral identifier.

The third component is optional. If used, it should contain the application identifier for the referred-to or external applications (i.e., not the originating application). The application identifier is a string of up to 15 characters that is uniquely associated with an application. A given healthcare provider facility, or group of intercommunicating healthcare provider facilities, should establish a unique list of applications that may be potential originators and recipients, and then assign unique application identifiers to each of those applications. This list of application identifiers becomes one of the healthcare provider facility's master dictionary lists. Since applications fulfilling different application roles can send and receive referral messages, the assigning authority application identifier may not identify the application sending or receiving a particular message. Data elements on the Message Header (MSH) segment are available to identify the actual sending and receiving applications.

RF1-7: Effective Date (DTM) 01143

Definition: This field contains the date on which the referral is effective.

RF1-8: Expiration Date (DTM) 01144

Definition: This field contains the date on which the referral expires.

RF1-9: Process Date (DTM) 01145

Definition: This field contains the date on which the referral originated. It is used in cases of retroactive approval.

RF1-10: Referral Reason (CWE) 01228

Definition: This field contains the reason for which the referral will take place. Refer to User-defined Table 0336 - Referral Reason for suggested values.

RF1-11: External Referral Identifier (EI) 01300

Definition: This field contains an external application's permanent identifier for the referral. That is, this referral identifier does not belong to the application that originated the referral and assigned the originating referral identifier.

The first component is a string of up to 15 characters that identifies an individual referral. It is typically assigned by the referred-to provider application responding to a referral originating from a referring provider application, and it identifies a referral, and the subsequent referral transactions, uniquely among all such referrals for a particular referred-to provider processing application. For example, when a primary care provider (referring provider) sends a referral to a specialist (referred-to provider), the specialist's application system may accept the referral and assign it a new referral identifier which uniquely identifies that particular referral within the specialist's application system. This new referral identifier would be placed in the external referral identifier field when the specialist responds to the primary care physician.

The second component is optional because this field, itself, is already defined as a referral identifier.

The third component is optional. If used, it should contain the application identifier for the referred-to or external application (i.e., not the originating application). The application identifier is a string of up to 15 characters that is uniquely associated with an application. A given healthcare provider facility, or group of intercommunicating healthcare provider facilities, should establish a unique list of applications that may be potential originators and recipients, and then assign unique application identifiers to each of those applications. This list of application identifiers becomes one of the healthcare provider facility's master dictionary lists. Since applications fulfilling different application roles can send and receive referral messages, the assigning authority application identifier may not identify the application sending or receiving a particular message. Data elements on the Message Header (MSH) segment are available to identify the actual sending and receiving applications.

RF1-12: Referral Documentation Completion Status (CWE) 02262

Definition: This field can be used to indicate to the receiving provider that the clinical history in the message is incomplete and that more will follow. Refer to User-defined Table 0865 - Referral Documentation Completion Status for suggested values.

RF1-13: Planned Treatment Stop Date (DTM) 03400

Definition: The planned treatment stop date is the date that the patient's treatment from this referral is expected to complete, based on procedural protocols. This value can be used to indicate that an extension to an authorization is necessary, if the treatment continues longer than expected.

RF1-14: Referral Reason Text (ST) 03401

Definition: The referral reason is a free text field allowing a user to capture, in a non-coded format, the reason for the referral. Typically this would describe the patient's condition or illness for which the referral is recorded.

RF1-15: Number of Authorized Treatments/Units (CQ) 03402

Definition: The authorized duration is the amount of time, in days or visits, that the patient has been authorized for treatment for this referral. The duration of "days" is reserved for inpatient authorizations.

RF1-16: Number of Used Treatments/Units (CQ) 03403

Definition: The used duration is the amount of time, in days or visits that the patient has used of the originally authorized duration. The duration of "days" is reserved for inpatient authorizations.

RF1-17: Number of Schedule Treatments/Units (CQ) 03404

Definition: The scheduled treatments is the amount of time, in days or visits that the patient has planned treatments scheduled. The duration of "days" is reserved for inpatient authorizations.

RF1-18: Remaining Benefit Amount (MO) 03405

Definition: The remaining benefit amount is the amount remaining from the insurance company related to this referral.

RF1-19: Authorized Provider (XON) 03406

Definition: This represents the organization to which the patient was referred to perform the procedure(s). The authorized provider represents the organization recognized by the insurance carrier that is authorized to perform the services for the patient specified on the referral.

RF1-20: Authorized Health Professional (XCN) 03407

Definition: The authorized HP represents the specific health professional authorized to perform the services for the patient. This is a less frequently used field, as most often the authorization is for a group/organization and not a specific HP within that group.

RF1-21: Source Text (ST) 03408

Definition: The source text allows a user to capture information (such as the name) of the person contacted regarding the specific referral.

RF1-22: Source Date (DTM) 03409

Definition: The source date allows a user to capture the date the person was contacted regarding the specific referral.

RF1-23: Source Phone (XTN) 03410

Definition: The source phone number allows a user to capture the phone number of the person contacted regarding the specific referral.

RF1-24: Comment (ST) 03411

Definition: The comment allows for a free text capture of any notes the user wishes to capture related to the referral. This is a single notes field that allows the user to add additional text over time, or replace the text that already exists.

RF1-25: Action Code (ID) 03412

Definition: This field defines the action to be taken for this referral. Refer to HL7 Table 0206 - Segment Action Code in Chapter 2, Code Tables, for valid values. When this field is valued, the AUT segment is not in "snapshot mode", rather in "action mode".