Healthcare Financial Services IG Edition 1 - Local Development build (v0.3.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Error Notice

Overview

When nphies receives a response message back in the same communication session as it sends a request message to an insurer or TPA, if the response message fails validation then nphies will queue an Error Notice for the insurer or TPA to advise them of the error(s) and provide message identifiers (MessageHeader.id) to assist the insurer or TPA in determining the issue(s).

Workflow

1. nphies sends an Error Notice Message to the insurer, or TPA, system to advise that a prior message from that system contained errors.
2. The insurer or TPA processes the notice and returns an Acknowledgement Message with a status of OK if the message is understood, that is the error code(s) indicated are valid and the message exchange being referenced is known, otherwise the acknowlegement contains an OperationOutcome resource indicating errors in the Error Notice Message.
3. nphies validates the response and, if valid, complets the exchange and removes it from the queue otherwise, a new Error Notice Message is generated.

This is a REAL TIME use case. If nphies is unable to connect with or exchange the message with the insurer or TPA then it will try again later.

Message Structures

Error Notice Message

The key resources for the message are provided below and all require nphies-profiled resources as provided in the Artifacts. Note: the MessageHeader resource must be the first .entry in the bundle and any other resources may follow in any order.

Nphies Bundle (.type = message )
  Nphies MessageHeader Error-Notice (.eventCoding = error-notice)
  Nphies OperationOutcome
  [any additional resources]

The Message-Header Error-Notice profile contains one or both of two key extensions:

• originalRequest containing the identifier (MessageHeader.id) of the request message from the exchange where the invalid message was sent from the insurer or TPA.
• originalResponse containing the identifier (MessageHeader.id) of the response message, if nphies could find one.

These message identifers are provided to aid the insurer, or TPA, in identifying which message response was invalid so that they may amend their system and send a new valid response to the request message to nphies.

Acknowledgement Message

See Acknowledgement Message.

Guidance

An Error Notice identifies the exchange in which an invalid response was provided by the insurer or TPA through the provision of one or more of the originalRequest or originalResponse extensions containing the identifiers (MessageHeader.id) for the respective message bundles. Upon receipt the insurer or TPA SHALL evaluate the notice and return an Acknowledgement Message with a MessageHeader.response.identifier containing the id of the Error-Notice Message and either:

• a MessageHeader.response.status code of ok to acknowlege receipt of a valid message; or
• a MessageHeader.response.status code of fatal-error and a reference to an OperationOutcome in the Bundle.entry array in Message.response.details.

Full Message Examples

Key Extensions

Error Handling

If nphies detects errors in the request message such that the request cannot be processed then the response message will contain an OperationOutcome resource rather than a business-level Status Response resource. Otherwise if nphies detects errors within the request it will return a Status Response with errors (Task.output.type = ‘error’) and an extension indicating where the error occurred.

Like all other response messages the provider receives from nphies, if there are other messages queued at nphies which have not been delivered to the provider then this will be reflected in the presence of a MessageHeader.meta.tag.