HCR01 — Action Code (X12 element 1371)
A3 — Not Certified
Draft — pending verification
This reference entry has not yet been verified against its authoritative source (X12 005010X217 TR3 — verify against licensed copy). Do not rely on it for production configuration until this notice is removed.
How A3 is used
Returned in HCR01 with reason detail in the accompanying segments and the plan's appeal pathway available to the requester (see UM02 appeal certification types).
Example
An MRI request without documented conservative treatment returns HCR01 = A3 with the specific clinical reason.
Where it lives in the transaction
A3 is a value of HCR01 — Action Code (X12 element 1371), carried in the HCR (Health Care Services Review), 278 response of the 278 Health Care Services Review — Response (005010X217). For the payer-side view of how PA Bridge normalizes these codes across X12 and FHIR intake, see the articles section.