Standards & EDI
HCR Action Code
Draft — pending verification
This reference entry has not yet been verified against its authoritative source (Original definitions; regulatory facts to be verified against CMS-0057-F (89 FR 8758) and X12/HL7 documentation). Do not rely on it for production configuration until this notice is removed.
In more depth
Every downstream behavior keys off HCR01 — claims matching for approvals, appeal workflows for denials, follow-up clocks for pends. Mapping payer-portal statuses and FHIR ClaimResponse outcomes onto the HCR vocabulary consistently is a prerequisite for unified authorization dashboards.