ASC X12 Finance Subcommittee Consumer Service Provider ...calling 1-888-363-2334. VERSION 003 ù...

ASC X12 FINANCE SUBCOMMITTEE VERSION 003 ùù RELEASE 061CSP BILLING AND PAYMENT GUIDE 814

JUNE 1996 VERSION 1.0 814

ASC X12 Finance Subcommittee

Consumer Service Provider (CSP)Billing and Payment Guide

Version 003 Release 061

Biller

- CSP -Consumer

Service Provider

PaymentSystem

Consumer Network

814 General Request, Response or ConfirmationTransaction Set Section

VERSION 003 ùù RELEASE 061 ASC X12 FINANCE SUBCOMMITTEE814 CSP BILLING AND PAYMENT GUIDE

814 ùù ii VERSION 1.0 JUNE 1996

DISA © 1996Copyright by Data Interchange Standards Association, Inc.All rights reserved throughout the world.


JUNE 1996 VERSION 1.0 814 ùù iii

Preface

Organization of Guide

This document should be treated as a guide or education and implementation tool. It is intended to aid inthe consistent use of Accredited Standards Committee (ASC) X12 standards within and across multipleindustries when implementing consumer electronic billing and payment through third party consumerservice providers.

The following are the documents (sections) that make up the Consumer Service Provider (CSP) Billingand Payment Guide.1. General Section2. 814 - General Request, Response or Confirmation Transaction Set Section3. 810 - Invoice Transaction Set Section4. 820 - Payment Order/Remittance Advice Transaction Set Section

Acknowledgments

This guide was prepared by members of the Finance Subcommittee organized and established by ASCX12. The X12 Finance Subcommittee developed and maintains the referenced standards as well as thisguide. Responsibility for the content of this guide resides specifically with the Consumer ServiceProvider Billing and Payment Work Group (WG4) of the Invoice and Payment Task Group (TG2) of theASC X12 Finance Subcommittee. The information contained in this document is based on the input ofX12 Finance Subcommittee member organizations, third party service providers and financialinstitutions.

Comments, questions, and suggestions for improvement from any trading partner, financial institution orthird party are strongly encouraged and may be submitted in writing to the secretariat of ASC X12, theData Interchange Standards Association, Inc. (DISA) using the contact information listed on the followingpage. They will be forwarded to the X12 Finance Subcommittee.

Obtaining Document Copies

This document is available in multiple formats.

1. Electronic DownloadAn electronic version of this document is available for download. It may be accessed through

the DISA World Wide Web Internet site listed on the following page. This document is located underthe X12 Finance Subcommittee (X12F) page, under the Documents.

2. DisketteAn electronic version of this document is available on diskette from DISA using the contact

information listed on the following page.

3. PaperA copy of this document is available on paper from DISA using the contact information listed on

the following page.

The ASC X12 standards mentioned in this document are available from DISA and may be ordered bycalling 1-888-363-2334.


814 ùù iv VERSION 1.0 JUNE 1996

DISA Contact Information

Data Interchange Standards Association, Inc.Director, Publications & Standards1800 Diagonal Road, Suite 200Alexandria, VA 22314-2852Phone: (703) 548-7005Fax: (703) 548-5738Email: [email protected]

Additional information on DISA, ASC X12 and the X12 Finance Subcommittee may be obtained on theDISA World Wide Web Internet site at:

http://www.disa.org


JUNE 1996 VERSION 1.0 814 ùù v

814 General Request, Response or Confirmation

Table of Contents

1. Overview ..........................................................................................................................................1-11.1 Description ..................................................................................................................................1-11.2 Transaction Set Usage ................................................................................................................1-1

1.2.1 General.................................................................................................................................1-11.2.2 Structure Information ............................................................................................................1-1

1.3 Segment Usage...........................................................................................................................1-22. Mapping Examples ...........................................................................................................................2-1

2.1 Example 1 - Transaction Set used as a Request from a CSP ......................................................2-12.2 Example 2 - Transaction Set used as a Response from Biller......................................................2-6

3. Cross Reference...............................................................................................................................3-14. Detail Layout ....................................................................................................................................4-1


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This Page Intentionally Blank

ASC X12 FINANCE SUBCOMMITTEE VERSION 003 ùù RELEASE 061CSP BILLING AND PAYMENT GUIDE 814 ùù 1- OVERVIEW

JUNE 1996 VERSION 1.0 814 ùù 1-1


1. Overview

1.1 Description

The 814 is an EDI General Request, Response or Confirmation transaction set. It is used to maintain therelationship between the Biller and the CSP on behalf of the Consumer. The CSP will send the 814transaction set to the Biller to Request electronic services of the Biller on behalf on the Consumer. TheBiller will send the 814 transaction set to the CSP in Response to the original Request transaction set.

1.2 Transaction Set Usage

1.2.1 General

The 814 transaction set is considered a one-to-many transaction. The CSP will create ONE 814 GeneralRequest, Response or Confirmation transaction set for MANY Consumer requests. The Biller will createONE 814 General Request, Response or Confirmation transaction set for MANY Consumer responses.

1.2.2 Structure Information

The following structure charts show how each transaction set table is used.

Table 1 - General Invoice InformationType of Action Type of Information SegmentIdentifyTransaction

Transaction Identifiers BGN

Transaction Currency (Optional) CURIdentify Sender &Receiver

Biller N1 Loop, Biller/Seller (SE Qualifier)

CSP N1 Loop, CSP (8S Qualifier)

Table 2 - Invoice Item InformationOne Line Item per Consumer Item requested.Type of Action Type of Information SegmentIdentify Service Line Item Consumer Electronic Service LIN

Line Item Action and/or Status ASILine Item Reference Numbers REFLine Item Dates DTMLine Item Currency CURLine Item Amount AMTLine Item Electronic Funds Information PM

Identify Line ItemParties

Consumer NM1 Loop, CSP Customer(8R Qualifier)

Buying Party, When Different then CSPCustomer

NM1 Loop, Buying Party(BY Qualifier)

Insured Party NM1 Loop, Insured or Subscriber(IL Qualifier)

Property NM1 Loop, Property (PP Qualifier)

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814 ùù 1-2 VERSION 1.0 JUNE 1996

1.3 Segment Usage

BGN - Beginning Segment

The BGN Segment indicates the PURPOSE of the Transaction: REQUEST or RESPONSE.

LIN - Line Identification Segment

The LIN Segment indicates the ELECTRONIC SERVICE. Valid services are: EI - Electronic Invoicing,ED- Electronic Debit, or EC - Electronic Credit.

ASI - Action or Status Indicator Segment

On a REQUEST the ASI segment is used to indicate the ACTION to be taken with the line item specifiedin the LIN Segment. Valid actions are: Add, Change, Delete, Inquiry.

On a RESPONSE the ASI segment is used to report the STATUS of the requested ACTION and thereason for a rejected status. Data element 641 Status Reason Code is used to report the rejected statusas follows:

CODE DEFINITION & EXPLANATIONA75 Invalid Account FormatA76 Account Not FoundA77 Name Specified Does Not Match AccountA78 Item/Service Already Established, Cannot AddA79 Item/Service Not Established, Cannot ModifyA80 Item/Service Not AvailableA81 Item/Service Not Available on Requested DateA82 Address Specified Does Not Match AccountA83 Unauthorized or Invalid Action

Using the BGN and ASI Segments

The following are the combinations of the codes to be used in the BGN and ASI Segments:BGN01 ASI01 ASI02Data Element DE 353 Data Element 306 Data Element 875Transaction Set Purpose Action Code Maintenance Type CodeCode identifying purpose oftransaction set

Code indicating type of action Code Identifying the specifictype of maintenance

13 Request (CSP to Biller) 7 Request 001 Change002 Delete021 Addition029 Inquiry

11 Response (Biller to CSP) WQ Accept 001 Change002 Delete021 Addition029 Inquiry

U Reject 001 Change002 Delete021 Addition029 Inquiry

ASC X12 FINANCE SUBCOMMITTEE VERSION 003 ùù RELEASE 061CSP BILLING AND PAYMENT GUIDE 814 ùù 2- MAPPING EXAMPLES



2. Mapping Examples

2.1 Example 1 - Transaction Set used as a Request from a CSP

Example 1 - Business Scenario

ABC Company is a large biller (such as a utility, cable company, telephone company, or credit cardprocessor). 123 Easy Pay is a Consumer Service Provider (CSP) which provides consumers and smallbusinesses with bill payment services using PC software, including electronic invoicing and paymentswith large billers. 123 Easy Pay has four customers, Joe Doe, Mary Q. Smith, Sue Parks & Fred Jones.

Example 1 - Transaction Scenario

Several consumers make a request for electronic services from ABC Company through 123 Easy Payusing their PC software. 123 Easy Pay consolidates the consumer requests and creates an EDI 814transaction set to transfer the consolidated requests to ABC Company.

Biller CSP

Cons umer

ABC Company Joe, Mary, Sue, Fred123 Easy Pay

814

Example 1 - Transaction Participant Information

Transaction Receiver Biller Name: ABC Company ID: 999999999Transaction Sender CSP Name: 123 Easy Pay ID: 123000000Service Requested for Consumers Name: Joe Doe ID: 123-DOE

Name: Mary Q. Smith ID: 123-SMITH Pays bills for: Granny Smith

Name: Sue Parks ID: 123-PARKSName: Fred Jones ID: 123-JONES

Example 1 - Transaction Request Information

Joe Doe Wants electronic invoicing for himself for Biller ABC account ABC-000-0024Mary Q. Smith Wants electronic invoicing for herself for Biller ABC account ABC-000-1234

Wants electronic invoicing for Granny Smith for Biller ABC account ABC-000-9876Sue Parks Wants electronic credit through 123 Easy Pay for Biller ABC account ABC-000-1111

123 Easy Pay wants to verify the account numberFred Jones Wants recurring electronic debit for amount of invoice

for Biller ABC account ABC-000-3322 on the 5th day of each month

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Example 1 - Transaction Set Mapping

Table 1Segment Contents Element DescriptionsST*814*0001 n/l Transaction Set ID: 814 Transaction Set

Control Number: 0001BGN*13*123-456789*950105*092614 n/l Transaction Set Purpose Code: 13, Request

Reference Number: 123-456789, Transaction IdentifierDate: 950105, Transaction DateTime: 092614, Transaction Time

N1*SE*ABC COMPANY*1*999999999n/l

Entity Identifier Code: SE, Seller followsName: ABC COMPANY (4)Identification Code Qualifier: 1, DUNS number followsIdentification Code: 999999999

N3*P.O. BOX 930170 n/l Address: P.O. BOX 930170N4*DALLAS*TX*753930170 n/l City: DALLAS

State: TXPostal Code: 75393-0170

N1*8S*123 EASY PAY*1*123000000 n/l Entity Identifier Code: 8S, Consumer Service Provider(CSP) followsName: 123 EASY PAYIdentification Code Qualifier: 1, DUNS Number followsIdentification Code: 123000000

N3*1234 MAIN STREET n/l Address: 1234 MAIN STREETN4*ST. LOUIS*MO*631013736 n/l City: ST. LOUIS

State: MOPostal Code: 63101-3736

Table 2Segment Contents Element DescriptionsLIN*1*SH*EI n/l Assigned Identification: 1

Product/Service ID Qualifier: SH, Service RequestedProduct/Service ID: EI, Electronic Invoicing

ASI*7*021 n/l Action Code: 7, RequestMaintenance Type Code: 021, Addition

REF*TN*AA220001 n/l Reference Number Qualifier: TN, Transaction NumberfollowsReference Number: AA220001 , CSP Transaction Number

REF*11*ABC-000-0024 n/l Reference Number Qualifier: 11, Account Number followsReference Number: ABC-000-0024 , Account Number

DTM*211*950104 n/l Date/Time Qualifier: 211, Service requested date followsDate:950104

NM1*8R*1*DOE*JOE****92*123-DOE n/l Entity Identifier Code: 8R, Consumer Service Provider(CSP) Customer followsEntity Type Qualifier: 1, PersonLast Name or Organization Name: DOEName First: JOEName Middle: N/AName Prefix: N/AName Suffix: N/AIdentification Code Qualifier: 92, Assigned by Buyer orBuyer's AgentIdentification Code: 123-DOE



Segment Contents Element DescriptionsLIN*2*SH*EI n/l Assigned Identification: 2






NM1*8R*1*SMITH*MARY*Q***92*123-SMITH n/l

Entity Identifier Code: 8R, Consumer Service Provider(CSP) Customer followsEntity Type Qualifier: 1, PersonLast Name or Organization Name: SMITHName First: MARYName Middle: QName Prefix: N/AName Suffix: N/AIdentification Code Qualifier: 92, Assigned by Buyer orBuyer's AgentIdentification Code: 123-SMITH

LIN*3*SH*EI n/l Assigned Identification: 3Product/Service ID Qualifier: SH, Service RequestedProduct/Service ID: EI, Electronic Invoicing







NM1*BY*1*SMITH*GRANNY n/l Entity Identifier Code: BY, Buyer followsEntity Type Qualifier: 1, PersonLast Name or Organization Name: SMITHName First: GRANNY

LIN*4*SH*EC n/l Assigned Identification: 4Product/Service ID Qualifier: SH, Service RequestedProduct/Service ID: EC, Electronic Credit



Segment Contents Element DescriptionsASI*7*029 n/l Action Code: 7, Request

Maintenance Type Code: 029, InquiryREF*TN*AA220001 n/l Reference Number Qualifier: TN, Transaction Number

followsReference Number: AA220661 , CSP Transaction Number


NM1*8R*1*PARKS*SUE****92*123-PARKS n/l

Entity Identifier Code: 8R, Consumer Service Provider(CSP) Customer followsEntity Type Qualifier: 1, PersonLast Name or Organization Name: PARKSName First: SUEName Middle: N/AName Prefix: N/AName Suffix: N/AIdentification Code Qualifier: 92, Assigned by Buyer orBuyer's AgentIdentification Code: 123-PARKS

LIN*5*SH*ED n/l Assigned Identification: 5Product/Service ID Qualifier: SH, Service RequestedProduct/Service ID: ED, Electronic Debit




DTM*802*****05 n/l Date/Time Qualifier: 802, Date of Action (Recurring Debit)followsDate:N/ATime:N/ATime Code:N/ACentury:N/ADate Time Period Format Qualifier: DD, Day of MonthDate Time Period: 05, Fifth day of month

AMT*TP*0 n/l Amount Qualifier: TP, Total Payment Amount followsMonetary Amount:0, Amount does not apply, use totalinvoice amount

PM*111111111*66666666*Y*Y*DA n/l (DFI) Identification Number: 111111111Account Number: 66666666Yes/No Condition Response Code: Y, Yes, Authorizationfor EFT grantedYes/No Condition Response Code: Y, Yes, Signature forEFT on fileAccount Number Qualifier: DA, Demand Deposit



Segment Contents Element DescriptionsNM1*8R*1*JONES*FRED****92*123-JONES n/l

Entity Identifier Code: 8R, Consumer Service Provider(CSP) Customer followsEntity Type Qualifier: 1, PersonLast Name or Organization Name: JONESName First: FREDName Middle: N/AName Prefix: N/AName Suffix: N/AIdentification Code Qualifier: 92, Assigned by Buyer orBuyer's AgentIdentification Code: 123-JONES

Table 3Segment Contents Element DescriptionsSE*41*0001 n/l Number of Segments: 41

Transaction Set Control Number: 0001



2.2 Example 2 - Transaction Set used as a Response from Biller

Example 2 - Business Scenario

ABC Company is a large biller (such as a utility, cable company, telephone company, or credit cardprocessor). 123 Easy Pay is a Consumer Service Provider (CSP) which provides consumers and smallbusinesses with bill payment services using PC software, including electronic invoicing and paymentswith large billers. 123 Easy Pay has four customers, Joe Doe, Mary Q. Smith, Sue Parks & Fred Jones.

Example 2 - Transaction Scenario

Several consumers make a request for electronic services from ABC Company through 123 Easy Payusing their PC software.

Previously, 123 Easy Pay consolidates the consumer requests and creates an EDI 814 transaction set totransfer the consolidated requests to ABC Company (See Example 1 in this section).

ABC Company processes the Request from 123 Easy Pay and creates an EDI 814 transaction set inResponse. The Response will show the status of each of the consolidated consumer requests.

Biller CSP

Cons umer

ABC Company Joe, Mary, Sue, Fred123 Easy Pay

814

Example 2 - Transaction Participant Information

Transaction Sender Biller Name: ABC Company ID: 999999999Transaction Receiver CSP Name: 123 Easy Pay ID: 123000000Service Response for Consumers Name: Joe Doe ID: 123-DOE

Name: Mary Q. Smith ID: 123-SMITH Pays bills for: Granny Smith

Name: Sue Parks ID: 123-PARKSName: Fred Jones ID: 123-JONES

Example 2 - Transaction Response Information

Joe Doe Electronic invoicing, Set up acceptedfor Biller ABC account ABC-000-0024

Mary Q. Smith Electronic invoicing for herself, Set up rejected (Account not found)for Biller ABC account ABC-000-1234

Electronic invoicing for Granny Smith, Set up acceptedfor Biller ABC account ABC-000-9876

Sue Parks Electronic credit through 123 Easy Pay, Account accepted/verifiedfor Biller ABC account ABC-000-1111

Fred Jones Recurring electronic debit for amount of invoice, Set up acceptedfor Biller ABC account ABC-000-3322on the 5th day of each month



Example 2 - Transaction Set Mapping

Table 1Segment Contents Element DescriptionsST*814*0001 n/l Transaction Set ID: 814 Transaction Set

Control Number: 0001BGN*11*9501060002*950106*150233n/l

Transaction Set Purpose Code: 11, ResponseReference Number: 9501060002, Transaction IdentifierDate: 950106, Transaction DateTime: 150233, Transaction Time

N1*SE*ABC COMPANY*1*999999999n/l

Entity Identifier Code: SE, Seller followsName: ABC COMPANY (4)Identification Code Qualifier: 1, DUNS number followsIdentification Code: 999999999

N3*P.O. BOX 930170 n/l Address: P.O. BOX 930170N4*DALLAS*TX*753930170 n/l City: DALLAS

State: TXPostal Code: 75393-0170

N1*8S*123 EASY PAY*1*123000000 n/l Entity Identifier Code: 8S, Consumer Service Provider(CSP) followsName: 123 EASY PAYIdentification Code Qualifier: 1, DUNS Number followsIdentification Code: 123000000

N3*1234 MAIN STREET n/l Address: 1234 MAIN STREETN4*ST. LOUIS*MO*631013736 n/l City: ST. LOUIS

State: MOPostal Code: 63101-3736

Table 2Segment Contents Element DescriptionsLIN*1*SH*EI n/l Assigned Identification: 1


ASI*WQ*021 n/l Action Code: WQ, AcceptedMaintenance Type Code: 021, Addition



DTM*150*950107 n/l Date/Time Qualifier: 150, Service period startDate:950107

NM1*8R*1*DOE*JOE****92*123-DOE n/l Entity Identifier Code: 8R, Consumer Service Provider(CSP) Customer followsEntity Type Qualifier: 1, PersonLast Name or Organization Name: DOEName First: JOEName Middle: N/AName Prefix: N/AName Suffix: N/AIdentification Code Qualifier: 92, Assigned by Buyer orBuyer's AgentIdentification Code: 123-DOE



Segment Contents Element DescriptionsLIN*2*SH*EI n/l Assigned Identification: 2


ASI*U*021*A76 n/l Action Code: U, RejectedMaintenance Type Code: 021, AdditionStatus Reason Code: A76, Account Not Found





LIN*3*SH*EI n/l Assigned Identification: 3Product/Service ID Qualifier: SH, Service RequestedProduct/Service ID: EI, Electronic Invoicing







NM1*BY*1*SMITH*GRANNY n/l Entity Identifier Code: BY, Buyer followsEntity Type Qualifier: 1, PersonLast Name or Organization Name: SMITHName First: GRANNY

LIN*4*SH*EC n/l Assigned Identification: 4Product/Service ID Qualifier: SH, Service RequestedProduct/Service ID: EC, Electronic Credit

ASI*WQ*029 n/l Action Code: WQ, AcceptedMaintenance Type Code: 029, Inquiry



Segment Contents Element DescriptionsREF*TN*AA220001 n/l Reference Number Qualifier: TN, Transaction Number

followsReference Number: AA220661 , CSP Transaction Number


NM1*8R*1*PARKS*SUE****92*123-PARKS n/l

Entity Identifier Code: 8R, Consumer Service Provider(CSP) Customer followsEntity Type Qualifier: 1, PersonLast Name or Organization Name: PARKSName First: SUEName Middle: N/AName Prefix: N/AName Suffix: N/AIdentification Code Qualifier: 92, Assigned by Buyer orBuyer's AgentIdentification Code: 123-PARKS

LIN*5*SH*ED n/l Assigned Identification: 5Product/Service ID Qualifier: SH, Service RequestedProduct/Service ID: ED, Electronic Debit





DTM*802*****05 n/l Date/Time Qualifier: 802, Date of Action (Recurring Debit)followsDate:N/ATime:N/ATime Code:N/ACentury:N/ADate Time Period Format Qualifier: DD, Day of MonthDate Time Period: 05, Fifth day of month

AMT*TP*0 n/l Amount Qualifier: TP, Total Payment Amount followsMonetary Amount:0, Amount does not apply, use totalinvoice amount

PM*111111111*66666666*Y*Y*DA n/l (DFI) Identification Number: 111111111Account Number: 66666666Yes/No Condition Response Code: Y, Yes, Authorizationfor EFT grantedYes/No Condition Response Code: Y, Yes, Signature forEFT on fileAccount Number Qualifier: DA, Demand Deposit


814 ùù 2-10 VERSION 1.0 JUNE 1996

Segment Contents Element DescriptionsNM1*8R*1*JONES*FRED****92*123-JONES n/l

Entity Identifier Code: 8R, Consumer Service Provider(CSP) Customer followsEntity Type Qualifier: 1, PersonLast Name or Organization Name: JONESName First: FREDName Middle: N/AName Prefix: N/AName Suffix: N/AIdentification Code Qualifier: 92, Assigned by Buyer orBuyer's AgentIdentification Code: 123-JONES

Table 3Segment Contents Element DescriptionsSE*41*0001 n/l Number of Segments: 41

Transaction Set Control Number: 0001

ASC X12 FINANCE SUBCOMMITTEE VERSION 003 ùù RELEASE 061CSP BILLING AND PAYMENT GUIDE 814 ùù 3 - CROSS REFERENCE



3. Cross Reference

The transaction set cross reference is a mapping aid. The cross reference can be used to map or to findthe location of data (data items) within the 814 transaction set.

The report column heading are explained below:

Column Column Name Column Description

Data Item Data Item Name Name of data.Use Use Sequential number identifying multiple uses or

locations for the data item.Type of Data Type of Data Valid values for the column are: ‘Qualifier’ or ‘Data’.

Mapping a data item may require one or morequalifiers to be used to identify the data item.Therefore, the Qualifier(s) and Data item locationsare both listed. The location of the qualifiers arelisted before the location of the data item.

TS ID Transaction Set ID Transaction set ID or number, such as: ‘810’, ‘814’,or ‘820’.

TS Tbl Transaction Set Table Transaction set table or area within the transactionset. Valid Values for this column are: ‘1’-Header/Heading, ‘2’-Detail, or ‘3’-Summary.

Seg Pos Segment Position The segment location within the transaction settable or area.

Loop ID Comment Loop ID Comment The loop qualifier or position within the transactionset table or area. Loops can occur multiple timeswithin a mapped transaction set. Each loopoccurrence is identified by the segment that startsthe loop. The loops are uniquely identified by aqualifier that is specified within the first segment ofthe loop. For example, ‘N1/Seller (SE)’ is the N1loop for the Seller that is qualified by the ‘SE’qualifier in the N1 segment.

Seg ID Segment ID The two or three character segment identifier.DE Pos Data Element Position The position of the data element within the specified

segment.DE Nbr Data Element Number The data element number that occurs at the

specified data element position.DE Name Data Element Name The data element name that occurs at the specified

data element position.DE Val Data Element Value The data element value to be used to qualify the

data element when the Type of Data column is‘Qualifier’. When the small letter ‘x’ is listed, theComments column will refer to additional values tobe used.

Comment Comment Comments which expand the definition of a dataelement value column or give additional informationon the data element value.

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Data Type of TS TS Seg Seg DE DE DE DEItem Use Data ID Tbl Pos Loop ID Comment ID Pos Nbr Name Val Comment


Account Number1 Qualifier 814 2 030 REF 01 128 Reference Number AP Accounts Receivable

Qualifier Number1 Data 814 2 030 REF 02 127 Reference Number

Account Type1 Qualifier 814 2 030 REF 01 128 Reference Number 9X Account Category

Qualifier1 Data 814 2 030 REF 02 127 Reference Number

Begin Service Date1 Qualifier 814 2 040 DTM 01 374 Date/Time Qualifier 150 Service Period

Start, Same asRequested ServiceStart Date

1 Data 814 2 040 DTM 02 373 Date

Biller Address1 Data 814 1 060 N1/Seller (SE) N3 01 166 Address Information Also N3021 Data 814 1 060 N1/Seller (SE) N3 02 166 Address Information Also N301

Biller City1 Data 814 1 070 N1/Seller (SE) N4 01 19 City Name

Biller Country1 Data 814 1 070 N1/Seller (SE) N4 04 26 Country Code

Biller ID1 Qualifier 814 1 040 N1/Seller (SE) N1 01 98 Entity Identifier SE Seller (Biller)

Code1 Qualifier 814 1 040 N1/Seller (SE) N1 03 66 Identification Code 1 D-U-N-S Number

Qualifier (Universal ID)1 Data 814 1 040 N1/Seller (SE) N1 04 67 Identification Code

Biller Name1 Qualifier 814 1 040 N1/Seller (SE) N1 01 98 Entity Identifier SE Seller (Biller)

Code1 Data 814 1 040 N1/Seller (SE) N1 02 93 Name

Biller Phone Number1 Qualifier 814 1 080 N1/Seller (SE) PER 01 366 Contact Function IC Information Contact

Code1 Qualifier 814 1 080 N1/Seller (SE) PER 03 365 Communication TE Telephone

Number Qualifier1 Data 814 1 080 N1/Seller (SE) PER 04 364 Communication

Number

Biller Phone Number Type1 Data 814 1 080 N1/Seller (SE) PER 01 366 Contact Function xx xx Contact Function

Code Code, See DE 366Codes

Biller State1 Data 814 1 070 N1/Seller (SE) N4 02 156 State or Province

Code

Biller Zip/Postal Code1 Data 814 1 070 N1/Seller (SE) N4 03 116 Postal Code

Billing Account Number1 Qualifier 814 2 030 REF 01 128 Reference Number 11 Account Number


Billing Location ID




1 Qualifier 814 2 030 REF 01 128 Reference Number LU Location NumberQualifier

1 Data 814 2 030 REF 02 127 Reference Number

CSP Address1 Data 814 1 060 N1/CSP (8S) N3 01 166 Address Information Also N3021 Data 814 1 060 N1/CSP (8S) N3 02 166 Address Information Also N301

CSP City1 Data 814 1 070 N1/CSP (8S) N4 01 19 City Name

CSP ID1 Qualifier 814 1 040 N1/CSP (8S) N1 01 98 Entity Identifier 8S Consumer Service

Code Provider (CSP)1 Qualifier 814 1 040 N1/CSP (8S) N1 03 66 Identification Code 1 D-U-N-S Number

Qualifier (Universal ID)1 Data 814 1 040 N1/CSP (8S) N1 04 67 Identification Code

CSP Name1 Qualifier 814 1 040 N1/CSP (8S) N1 01 98 Entity Identifier 8S Consumer Service

Code Provider (CSP)1 Data 814 1 040 N1/CSP (8S) N1 02 93 Name

CSP Phone Number1 Qualifier 814 1 080 N1/CSP (8S) PER 01 366 Contact Function IC Information Contact

Code1 Qualifier 814 1 080 N1/CSP (8S) PER 03 365 Communication TE Telephone

Number Qualifier1 Data 814 1 080 N1/CSP (8S) PER 04 364 Communication

Number

CSP State1 Data 814 1 070 N1/CSP (8S) N4 02 156 State or Province

Code

CSP ZIP/Postal Code1 Data 814 1 070 N1/CSP (8S) N4 03 116 Postal Code

Customer Account Type1 Qualifier 814 2 030 REF 01 128 Reference Number 9X Account Category,

Qualifier Same as Account Type1 Data 814 2 030 REF 02 127 Reference Number

Customer Address1 Data 814 2 100 NM1/Customer (8R) N3 01 166 Address Information Also N3021 Data 814 2 100 NM1/Customer (8R) N3 02 166 Address Information Also N301

Customer City1 Data 814 2 110 NM1/Customer (8R) N4 01 19 City Name

Customer Country1 Data 814 2 110 NM1/Customer (8R) N4 04 26 Country Code

Customer First Name1 Data 814 2 080 NM1/Customer (8R) NM1 04 1036 Name First

Customer Funding Bank Account1 Data 814 2 070 PM 02 508 Account Number1 Data 814 2 070 PM 05 569 Account Type xx xx Account Number

Qualifier, See DE 569Codes

Customer ID1 Qualifier 814 2 080 NM1/Customer (8R) NM1 01 98 Entity Identifier 8R Consumer Service

Code Provider (CSP)




Customer1 Qualifier 814 2 080 NM1/Customer (8R) NM1 08 66 Identification Code 92 Assigned by Buyer

Qualifier or Buyer's Agent1 Data 814 2 080 NM1/Customer (8R) NM1 09 67 Identification Code Customer ID at CSP

Customer Last Name1 Data 814 2 080 NM1/Customer (8R) NM1 03 1035 Name Last or

Organization Name

Customer Middle Initial1 Data 814 2 080 NM1/Customer (8R) NM1 05 1037 Name Middle

Customer Name1 Qualifier 814 2 080 NM1/Customer (8R) NM1 01 98 Entity Identifier 8R Consumer Service

Code Provider (CSP)Customer

1 Data 814 2 080 NM1/Customer (8R) NM1 03 1035 Name Last orOrganization Name

Customer Phone Number1 Qualifier 814 2 120 NM1/Customer (8R) PER 01 366 Contact Function IC Information Contact

Code1 Qualifier 814 2 120 NM1/Customer (8R) PER 03 365 Communication TE Telephone

Number Qualifier1 Data 814 2 120 NM1/Customer (8R) PER 04 364 Communication

Number

Customer SSN1 Qualifier 814 2 130 NM1/Customer (8R) REF 01 128 Reference Number SY Social Security

Qualifier Number1 Data 814 2 130 NM1/Customer (8R) REF 02 127 Reference Number2 Qualifier 814 2 130 NM1/Buyer (BY) REF 01 128 Reference Number SY Social Security

Qualifier Number2 Data 814 2 130 NM1/Buyer (BY) REF 02 127 Reference Number

Customer State1 Data 814 2 110 NM1/Customer (8R) N4 02 156 State or Province

Code

Customer Zip/Postal Code1 Data 814 2 110 NM1/Customer (8R) N4 03 116 Postal Code

Insured Address1 Data 814 2 100 NM1/Property (PP) N3 01 166 Address Information Also N3021 Data 814 2 100 NM1/Property (PP) N3 02 166 Address Information Also N301

Insured City1 Data 814 2 110 NM1/Property (PP) N4 01 19 City Name

Insured Country1 Data 814 2 110 NM1/Property (PP) N4 04 26 Country Code

Insured Name1 Qualifier 814 2 080 NM1/Insured (IL) NM1 01 98 Entity Identifier IL Insured or

Code Subscriber1 Data 814 2 080 NM1/Insured (IL) NM1 03 1035 Name Last or

Organization Name

Insured Property1 Qualifier 814 2 080 NM1/Property (PP) NM1 01 98 Entity Identifier PP Property

Code1 Data 814 2 080 NM1/Property (PP) NM1 03 1035 Name Last or

Organization Name

Insured State




1 Data 814 2 110 NM1/Property (PP) N4 02 156 State or ProvinceCode

Insured Zip1 Data 814 2 110 NM1/Property (PP) N4 03 116 Postal Code

Item (Transaction) Date1 Qualifier 814 2 040 DTM 01 374 Date/Time Qualifier 097 Transaction Date1 Data 814 2 040 DTM 02 373 Date

Item Amount1 Qualifier 814 2 060 AMT 01 522 Amount Qualifier TP Total Payment

Code Amount, Same asPayment Amount

1 Data 814 2 060 AMT 02 782 Monetary Amount

Item Currency Type1 Qualifier 814 1 030 CUR 01 98 Entity Identifier VN Vendor

Code1 Data 814 1 030 CUR 02 100 Currency Code xx xx = MXP-Mexican

Pesos, CAD-Canadian Dollar, USD-United States Dollar

2 Qualifier 814 2 050 CUR 01 98 Entity Identifier VN VendorCode

2 Data 814 2 050 CUR 02 100 Currency Code xx xx = MXP-MexicanPesos, CAD-Canadian Dollar, USD-United States Dollar

Item Description1 Qualifier 814 2 010 LIN 01 350 Assigned

Identification1 Qualifier 814 2 010 LIN 02 235 Product/Service ID SH Service Requested

Qualifier1 Data 814 2 010 LIN 03 234 Product/Service ID xx xx =

EI-Electronic Invoice,ED-Electronic Debit,EC-Electronic Credit

Item Reference Number1 Data 814 2 010 LIN 01 350 Assigned

Identification

Item Store Number1 Qualifier 814 2 030 REF 01 128 Reference Number ST Store Number


Payment Amount1 Qualifier 814 2 060 AMT 01 522 Amount Qualifier TP Total Payment

Code Amount1 Data 814 2 060 AMT 02 782 Monetary Amount

Payment Date (Initiated)1 Qualifier 814 2 040 DTM 01 374 Date/Time Qualifier 802 Date of Action

(Recurring Debit)1 Qualifier 814 2 040 DTM 06 1250 Date Time Period DD Day of Month

Format Qualifier1 Data 814 2 040 DTM 07 1251 Date Time Period Day of Month

Payment Effective Date1 Qualifier 814 2 040 DTM 01 374 Date/Time Qualifier 007 Effective Date1 Data 814 2 040 DTM 02 373 Date




Payment Type1 Qualifier 814 2 030 REF 01 128 Reference Number 9V Payment Category


Payor Type1 Qualifier 814 2 030 REF 01 128 Reference Number 9W Payor Category


Policy Number1 Qualifier 814 2 030 REF 01 128 Reference Number IG Insurance Policy

Qualifier Number1 Data 814 2 030 REF 02 127 Reference Number

Policy Type1 Qualifier 814 2 030 REF 01 128 Reference Number TV Line of Business

Qualifier (ACORD Codes)1 Data 814 2 030 REF 02 127 Reference Number

Requested Service Start Date1 Qualifier 814 2 040 DTM 01 374 Date/Time Qualifier 150 Service Period

Start1 Data 814 2 040 DTM 02 373 Date

Routing Code1 Data 814 2 070 PM 01 507 (DFI)

IdentificationNumber

Third Party Address1 Data 814 2 100 NM1/Buyer (BY) N3 01 166 Address Information Also N3021 Data 814 2 100 NM1/Buyer (BY) N3 02 166 Address Information Also N301

Third Party City1 Data 814 2 110 NM1/Buyer (BY) N4 01 19 City Name

Third Party Country1 Data 814 2 110 NM1/Buyer (BY) N4 04 26 Country Code

Third Party ID1 Qualifier 814 2 080 NM1/Buyer (BY) NM1 01 98 Entity Identifier BY Buying Party

Code1 Qualifier 814 2 080 NM1/Buyer (BY) NM1 08 66 Identification Code 91 Assigned by Seller

Qualifier or Seller's Agent1 Data 814 2 080 NM1/Buyer (BY) NM1 09 67 Identification Code

Third Party Name1 Qualifier 814 2 080 NM1/Buyer (BY) NM1 01 98 Entity Identifier BY Buying Party

Code1 Data 814 2 080 NM1/Buyer (BY) NM1 03 1035 Name Last or

Organization Name

Third Party State1 Data 814 2 110 NM1/Buyer (BY) N4 02 156 State or Province

Code

Type of Routing Code1 Qualifier 814 2 030 REF 01 128 Reference Number LU Location Number,

Qualifier Same as BillingLocation ID

1 Data 814 2 030 REF 02 127 Reference Number

ASC X12 FINANCE SUBCOMMITTEE VERSION 003 ùù RELEASE 061CSP BILLING AND PAYMENT GUIDE 814 ùù 4 - DETAIL LATOUT



4. Detail Layout

Purpose and ScopeThis Draft Standard for Trial Use contains the format and establishes the data contents of the GeneralRequest, Response or Confirmation (814) for use within the context of an Electronic Data Interchange(EDI) environment. This Standard can be used between two entities with an established EDI relationshipto request related electronic services, to respond to a request for related electronic services or to confirminformation related to electronic services.

Functional Group Code - GE

Areas(a) Data Segments that are not used are not listed or detailed in the document.(b) Data Elements that are mandatory are marked with 'M/U' for MUST USE in the far left-hand column.(c) Data Elements that are not used are marked with 'X' in far left-hand column.

Heading (Table 1): Page Pos. Seg. Req. Loop Notes and No. No. ID Name Des. Max.Use Repeat Comments

4-3 010 ST Transaction Set Header M 14-4 020 BGN Beginning Segment M 14-6 030 CUR Currency O 1

LOOP ID - N1 >14-8 040 N1 Name O 1 c14-9 050 N2 Additional Name Information O 24-10 060 N3 Address Information O 24-11 070 N4 Geographic Location O 14-12 080 PER Administrative Communications Contact O >14-13 090 REF Reference Identification O >14-14 100 DTM Date/Time Reference O >1

Detail (Table 2): Page Pos. Seg. Req. Loop Notes and No. No. ID Name Des. Max.Use Repeat Comments

LOOP ID - LIN >14-15 010 LIN Item Identification O 14-18 020 ASI Action or Status Indicator O 14-19 030 REF Reference Identification O >14-21 040 DTM Date/Time Reference O >14-22 050 CUR Currency O 14-24 060 AMT Monetary Amount O >14-25 070 PM Electronic Funds Transfer Information O 1

LOOP ID - NM1 >14-27 080 NM1 Individual or Organizational Name O 1 c24-29 090 N2 Additional Name Information O 24-30 100 N3 Address Information O 24-31 110 N4 Geographic Location O 14-32 120 PER Administrative Communications Contact O >14-33 130 REF Reference Identification O >14-34 140 DTM Date/Time Reference O >1

Summary (Table 3): Page Pos. Seg. Req. Loop Notes and No. No. ID Name Des. Max.Use Repeat Comments

4-35 010 SE Transaction Set Trailer M 1

VERSION 003 ùù RELEASE 061 ASC X12 FINANCE SUBCOMMITTEE814ùù 4 - DETAIL LAYOUT CSP BILLING AND PAYMENT GUIDE


Transaction Set Comments

1. The N1 loop is used to identify the transaction set sender and receiver.2. The NM1 loop is used to identify the parties associated with the individual line item (LIN), such as an

individual consumer in a third party Consumer Service Provider transaction.



Segment: ST Transaction Set HeaderPosition: 010

Loop:Level: Heading

Usage: MandatoryMax Use: 1Purpose: To indicate the start of a transaction set and to assign a control number

Syntax Notes:Semantic Notes: 1 The transaction set identifier (ST01) used by the translation routines of the

interchange partners to select the appropriate transaction set definition (e.g.,810 selects the Invoice Transaction Set).

Comments:

Data Element SummaryRef. DataDes. Element Name Attributes

M/U ST01 143 Transaction Set Identifier Code M ID 3/3Code uniquely identifying a Transaction Set Valid Value(s):

814 X12.393 General Request, Response orConfirmation Transaction Set

M/U ST02 329 Transaction Set Control Number M AN 4/9Identifying control number that must be unique within the transactionset functional group assigned by the originator for a transaction set The transaction set control number is assigned by the originator andis unique. A unique number aids in error reconciliation and research.



Segment: BGN Beginning SegmentPosition: 020

Loop:Level: Heading

Usage: MandatoryMax Use: 1Purpose: To indicate the beginning of a transaction set

Syntax Notes: 1 If BGN05 is present, then BGN04 is required.Semantic Notes: 1 BGN02 is the transaction set reference number.

2 BGN03 is the transaction set date.3 BGN04 is the transaction set time.4 BGN05 is the transaction set time qualifier.5 BGN06 is the transaction set reference number of a previously sent

transaction affected by the current transaction.Comments:

Notes: Identifies the 814 transaction set.


M/U BGN01 353 Transaction Set Purpose Code M ID 2/2Code identifying purpose of transaction set Valid Value(s):

11 Response13 Request

M/U BGN02 127 Reference Identification M AN 1/30Reference information as defined for a particular Transaction Set or asspecified by the Reference Identification Qualifier This data element should contain a unique transaction numbercreated by the originator.

M/U BGN03 373 Date M DT 6/6Date (YYMMDD) This data element should contain the transaction creation date.

BGN04 337 Time X TM 4/8Time expressed in 24-hour clock time as follows: HHMM, or HHMMSS,or HHMMSSD, or HHMMSSDD, where H = hours (00-23), M = minutes(00-59), S = integer seconds (00-59) and DD = decimal seconds;decimal seconds are expressed as follows: D = tenths (0-9) and DD =hundredths (00-99) This data element should contain the transaction creation time.

X BGN05 623 Time Code O ID 2/2Code identifying the time. In accordance with International StandardsOrganization standard 8601, time can be specified by a + or - and anindication in hours in relation to Universal Time Coordinate (UTC) time;since + is a restricted character, + and - are substituted by P and M inthe codes that follow

X BGN06 127 Reference Identification O AN 1/30Reference information as defined for a particular Transaction Set or asspecified by the Reference Identification Qualifier

X BGN07 640 Transaction Type Code O ID 2/2Code specifying the type of transaction

X BGN08 306 Action Code O ID 1/2Code indicating type of action



X BGN09 786 Security Level Code O ID 2/2Code indicating the level of confidentiality assigned by the sender tothe information following



Segment: CUR CurrencyPosition: 030

Loop:Level: Heading

Usage: OptionalMax Use: 1Purpose: To specify the currency (dollars, pounds, francs, etc.) used in a transaction

Syntax Notes: 1 If CUR08 is present, then CUR07 is required.2 If CUR09 is present, then CUR07 is required.3 If CUR10 is present, then at least one of CUR11 or CUR12 is required.4 If CUR11 is present, then CUR10 is required.5 If CUR12 is present, then CUR10 is required.6 If CUR13 is present, then at least one of CUR14 or CUR15 is required.7 If CUR14 is present, then CUR13 is required.8 If CUR15 is present, then CUR13 is required.9 If CUR16 is present, then at least one of CUR17 or CUR18 is required.10 If CUR17 is present, then CUR16 is required.11 If CUR18 is present, then CUR16 is required.12 If CUR19 is present, then at least one of CUR20 or CUR21 is required.13 If CUR20 is present, then CUR19 is required.14 If CUR21 is present, then CUR19 is required.

Semantic Notes:Comments: 1 See Figures Appendix for examples detailing the use of the CUR segment.

Notes: Currency associated with the transaction. Not recommended for domestictransactions.


M/U CUR01 98 Entity Identifier Code M ID 2/2Code identifying an organizational entity, a physical location, or anindividual This data element identifies the party using currency defined in theCurrency Code CUR02.

M/U CUR02 100 Currency Code M ID 3/3Code (Standard ISO) for country in whose currency the charges arespecified This data element is a three position alpha code of the ISO-4217.The primary codes used in North America are MXP - Mexican Peso CAD - Canadian Dollar USD - United States Dollar.

CUR03 280 Exchange Rate O R 4/10Value to be used as a multiplier conversion factor to convert monetaryvalue from one currency to another

CUR04 98 Entity Identifier Code O ID 2/2Code identifying an organizational entity, a physical location, or anindividual

CUR05 100 Currency Code O ID 3/3Code (Standard ISO) for country in whose currency the charges arespecified

CUR06 669 Currency Market/Exchange Code O ID 3/3Code identifying the market upon which the currency exchange rate isbased

X CUR07 374 Date/Time Qualifier X ID 3/3



Code specifying type of date or time, or both date and timeX CUR08 373 Date O DT 6/6

Date (YYMMDD)X CUR09 337 Time O TM 4/8

Time expressed in 24-hour clock time as follows: HHMM, or HHMMSS,or HHMMSSD, or HHMMSSDD, where H = hours (00-23), M = minutes(00-59), S = integer seconds (00-59) and DD = decimal seconds;decimal seconds are expressed as follows: D = tenths (0-9) and DD =hundredths (00-99)

X CUR10 374 Date/Time Qualifier X ID 3/3Code specifying type of date or time, or both date and time

X CUR11 373 Date X DT 6/6Date (YYMMDD)

X CUR12 337 Time X TM 4/8Time expressed in 24-hour clock time as follows: HHMM, or HHMMSS,or HHMMSSD, or HHMMSSDD, where H = hours (00-23), M = minutes(00-59), S = integer seconds (00-59) and DD = decimal seconds;decimal seconds are expressed as follows: D = tenths (0-9) and DD =hundredths (00-99)












Segment: N1 NamePosition: 040

Loop: N1Level: Heading

Usage: OptionalMax Use: 1Purpose: To identify a party by type of organization, name, and code

Syntax Notes: 1 At least one of N102 or N103 is required.2 If either N103 or N104 is present, then the other is required.

Semantic Notes:Comments: 1 This segment, used alone, provides the most efficient method of providing

organizational identification. To obtain this efficiency the "ID Code" (N104)must provide a key to the table maintained by the transaction processingparty.

2 N105 and N106 further define the type of entity in N101.Notes: The N1 loop is used to identify the transaction sender and receiver.


M/U N101 98 Entity Identifier Code M ID 2/2Code identifying an organizational entity, a physical location, or anindividual Valid Value(s):

8S Consumer Service Provider (CSP)SE Selling Party

N102 93 Name X AN 1/35Free-form name

N103 66 Identification Code Qualifier X ID 1/2Code designating the system/method of code structure used forIdentification Code (67) Valid Value(s):

1 D-U-N-S Number, Dun & Bradstreet9 D-U-N-S+4, D-U-N-S Number with Four Character

SuffixN104 67 Identification Code X AN 2/20

Code identifying a party or other codeX N105 706 Entity Relationship Code O ID 2/2

Code describing entity relationshipX N106 98 Entity Identifier Code O ID 2/2

Code identifying an organizational entity, a physical location, or anindividual



Segment: N2 Additional Name InformationPosition: 050


Usage: OptionalMax Use: 2Purpose: To specify additional names or those longer than 35 characters in length

Syntax Notes:Semantic Notes:

Comments:Notes: Additional sender or receiver names.


M/U N201 93 Name M AN 1/35Free-form name

N202 93 Name O AN 1/35Free-form name


814 ùù 4-10 VERSION 1.0 JUNE 1996

Segment: N3 Address InformationPosition: 060


Usage: OptionalMax Use: 2Purpose: To specify the location of the named party


Comments:Notes: Sender or receiver address information.


M/U N301 166 Address Information M AN 1/35Address information

N302 166 Address Information O AN 1/35Address information


JUNE 1996 VERSION 1.0 814 ùù 4-11

Segment: N4 Geographic LocationPosition: 070


Usage: OptionalMax Use: 1Purpose: To specify the geographic place of the named party

Syntax Notes: 1 If N406 is present, then N405 is required.Semantic Notes:

Comments: 1 A combination of either N401 through N404, or N405 and N406 may beadequate to specify a location.

2 N402 is required only if city name (N401) is in the U.S. or Canada.Notes: Sender or receiver address geographic location information.


N401 19 City Name O AN 2/30Free-form text for city name

N402 156 State or Province Code O ID 2/2Code (Standard State/Province) as defined by appropriate governmentagency

N403 116 Postal Code O ID 3/15Code defining international postal zone code excluding punctuation andblanks (zip code for United States)

N404 26 Country Code O ID 2/3Code identifying the country

N405 309 Location Qualifier X ID 1/2Code identifying type of location

N406 310 Location Identifier O AN 1/30Code which identifies a specific location


814 ùù 4-12 VERSION 1.0 JUNE 1996

Segment: PER Administrative Communications ContactPosition: 080


Usage: OptionalMax Use: >1Purpose: To identify a person or office to whom administrative communications should be

directedSyntax Notes: 1 If either PER03 or PER04 is present, then the other is required.

2 If either PER05 or PER06 is present, then the other is required.3 If either PER07 or PER08 is present, then the other is required.

Semantic Notes:Comments:

Notes: Sender or receiver information contacts and telephone numbers.


M/U PER01 366 Contact Function Code M ID 2/2Code identifying the major duty or responsibility of the person or groupnamed Valid Value(s):

IC Information ContactPER02 93 Name O AN 1/35

Free-form namePER03 365 Communication Number Qualifier X ID 2/2

Code identifying the type of communication number Valid Value(s):

TE TelephonePER04 364 Communication Number X AN 1/80

Complete communications number including country or area codewhen applicable

X PER05 365 Communication Number Qualifier X ID 2/2Code identifying the type of communication number

X PER06 364 Communication Number X AN 1/80Complete communications number including country or area codewhen applicable



X PER09 443 Contact Inquiry Reference O AN 1/20Additional reference number or description to clarify a contact number


JUNE 1996 VERSION 1.0 814 ùù 4-13

Segment: REF Reference IdentificationPosition: 090


Usage: OptionalMax Use: >1Purpose: To specify identifying information

Syntax Notes: 1 At least one of REF02 or REF03 is required.2 If either C04003 or C04004 is present, then the other is required.3 If either C04005 or C04006 is present, then the other is required.

Semantic Notes: 1 REF04 contains data relating to the value cited in REF02.Comments:

Notes: Reference number related to the sender or receiver.


M/U REF01 128 Reference Identification Qualifier M ID 2/3Code Qualifying the Reference Identification

REF02 127 Reference Identification X AN 1/30Reference information as defined for a particular Transaction Set or asspecified by the Reference Identification Qualifier

REF03 352 Description X AN 1/80A free-form description to clarify the related data elements and theircontent

X REF04 C040 Reference Identifier OTo identify one or more reference numbers or identification numbers asspecified by the Reference Qualifier

X C04001 128 Reference Identification Qualifier M ID 2/3Code Qualifying the Reference Identification

X C04002 127 Reference Identification M AN 1/30Reference information as defined for a particular Transaction Set or asspecified by the Reference Identification Qualifier

X C04003 128 Reference Identification Qualifier X ID 2/3Code Qualifying the Reference Identification

X C04004 127 Reference Identification X AN 1/30Reference information as defined for a particular Transaction Set or asspecified by the Reference Identification Qualifier




814 ùù 4-14 VERSION 1.0 JUNE 1996

Segment: DTM Date/Time ReferencePosition: 100


Usage: OptionalMax Use: >1Purpose: To specify pertinent dates and times

Syntax Notes: 1 At least one of DTM02 DTM03 or DTM06 is required.2 If either DTM06 or DTM07 is present, then the other is required.


Notes: Dates related to the sender or receiver.


M/U DTM01 374 Date/Time Qualifier M ID 3/3Code specifying type of date or time, or both date and time

DTM02 373 Date X DT 6/6Date (YYMMDD)

X DTM03 337 Time X TM 4/8Time expressed in 24-hour clock time as follows: HHMM, or HHMMSS,or HHMMSSD, or HHMMSSDD, where H = hours (00-23), M = minutes(00-59), S = integer seconds (00-59) and DD = decimal seconds;decimal seconds are expressed as follows: D = tenths (0-9) and DD =hundredths (00-99)

X DTM04 623 Time Code O ID 2/2Code identifying the time. In accordance with International StandardsOrganization standard 8601, time can be specified by a + or - and anindication in hours in relation to Universal Time Coordinate (UTC) time;since + is a restricted character, + and - are substituted by P and M inthe codes that follow

DTM05 624 Century O N0 2/2The first two characters in the designation of the year (CCYY)

X DTM06 1250 Date Time Period Format Qualifier X ID 2/3Code indicating the date format, time format, or date and time format

X DTM07 1251 Date Time Period X AN 1/35Expression of a date, a time, or range of dates, times or dates andtimes


JUNE 1996 VERSION 1.0 814 ùù 4-15

Segment: LIN Item IdentificationPosition: 010

Loop: LINLevel: Detail

Usage: OptionalMax Use: 1Purpose: To specify basic item identification data

Syntax Notes: 1 If either LIN04 or LIN05 is present, then the other is required.2 If either LIN06 or LIN07 is present, then the other is required.3 If either LIN08 or LIN09 is present, then the other is required.4 If either LIN10 or LIN11 is present, then the other is required.5 If either LIN12 or LIN13 is present, then the other is required.6 If either LIN14 or LIN15 is present, then the other is required.7 If either LIN16 or LIN17 is present, then the other is required.8 If either LIN18 or LIN19 is present, then the other is required.9 If either LIN20 or LIN21 is present, then the other is required.10 If either LIN22 or LIN23 is present, then the other is required.11 If either LIN24 or LIN25 is present, then the other is required.12 If either LIN26 or LIN27 is present, then the other is required.13 If either LIN28 or LIN29 is present, then the other is required.14 If either LIN30 or LIN31 is present, then the other is required.

Semantic Notes: 1 LIN01 is the line item identificationComments: 1 See the Data Dictionary for a complete list of IDs.

2 LIN02 through LIN31 provide for fifteen different product/service IDs foreach item. For example: Case, Color, Drawing No., UPC No., ISBN No.,Model No., or SKU.

Notes: Identifies the consumer electronic service.


LIN01 350 Assigned Identification O AN 1/20Alphanumeric characters assigned for differentiation within atransaction set This data element specifies a unique sequential number for thistransaction set. One per Line Item (LIN).

M/U LIN02 235 Product/Service ID Qualifier M ID 2/2Code identifying the type/source of the descriptive number used inProduct/Service ID (234) Valid Value(s):

SH Service RequestedA numeric or alphanumeric code from a list ofservices available to the customer

M/U LIN03 234 Product/Service ID M AN 1/40Identifying number for a product or service Valid Value(s):

EC Electronic CreditED Electronic DebitEI Electronic Invoicing

X LIN04 235 Product/Service ID Qualifier X ID 2/2Code identifying the type/source of the descriptive number used inProduct/Service ID (234)

X LIN05 234 Product/Service ID X AN 1/40


814 ùù 4-16 VERSION 1.0 JUNE 1996

Identifying number for a product or serviceX LIN06 235 Product/Service ID Qualifier X ID 2/2

Code identifying the type/source of the descriptive number used inProduct/Service ID (234)

X LIN07 234 Product/Service ID X AN 1/40Identifying number for a product or service





















JUNE 1996 VERSION 1.0 814 ùù 4-17







814 ùù 4-18 VERSION 1.0 JUNE 1996

Segment: ASI Action or Status IndicatorPosition: 020


Usage: OptionalMax Use: 1Purpose: To indicate the action to be taken with the information provided or the status of

the entity describedSyntax Notes:


Notes: Identifies the action to be taken or status of a requested action for the consumerelectronic service identified in the LIN segment.


M/U ASI01 306 Action Code M ID 1/2Code indicating type of action For REQUEST transactions (BGN01='13'), this data element shouldreflect the action to be performed - '7' (Request). For RESPONSE transactions (BGN01='11'), this data elementshould reflect the status of the action - 'WQ' (Accept) or 'U' (Reject). Valid Value(s):

7 RequestU Reject

Inability to accept for processing due to the lack ofrequired information

WQ AcceptM/U ASI02 875 Maintenance Type Code M ID 3/3

Code identifying the specific type of item maintenance Valid Value(s):

001 Change002 Delete021 Addition029 Inquiry

ASI03 641 Status Reason Code O ID 3/3Code indicating the status reason For RESPONSE transactions (BGN01='11'), when a reject isindicted (ASI01='U'), this data element should reflect reason for therejection. Valid Value(s):

A75 Invalid Account FormatA76 Account Not FoundA77 Name Specified Does Not Match AccountA78 Item or Service Already Established, Cannot AddA79 Item or Service Not Established, Cannot ModifyA80 Item or Service Not AvailableA81 Item or Service Not Available on Requested DateA82 Address Specified Does Not Match AccountA83 Unauthorized or Invalid Action


JUNE 1996 VERSION 1.0 814 ùù 4-19






Notes: Reference numbers related to the service identified in the LIN segment.


M/U REF01 128 Reference Identification Qualifier M ID 2/3Code Qualifying the Reference Identification This data element should contain the identifying reference numbersfor the action (service requested) . In most cases this will be anaccount or document number. Valid Value(s):

11 Account NumberNumber identifies a telecommunications industryaccount

9V Payment Category9W Payer Category9X Account CategoryAP Accounts Receivable NumberDP Department NumberIG Insurance Policy NumberLU Location NumberST Store NumberTV Line of Business

Indicates the nature of policy coverage; examplesof line of business include fire, homeowners, floodand earthquake

REF02 127 Reference Identification X AN 1/30Reference information as defined for a particular Transaction Set or asspecified by the Reference Identification Qualifier






814 ùù 4-20 VERSION 1.0 JUNE 1996






JUNE 1996 VERSION 1.0 814 ùù 4-21






Notes: Dates related to the service identified in the LIN segment.


M/U DTM01 374 Date/Time Qualifier M ID 3/3Code specifying type of date or time, or both date and time Valid Value(s):

007 Effective097 Transaction Creation150 Service Period Start802 Date of Action





DTM06 1250 Date Time Period Format Qualifier X ID 2/3Code indicating the date format, time format, or date and time format Valid Value(s):

DD Day of Month in Numeric FormatThe numeric day of the month expressed using alead zero if the number of the day is less than ten

DTM07 1251 Date Time Period X AN 1/35Expression of a date, a time, or range of dates, times or dates andtimes This data element is used when a Day of the Month is required. Do not use this data element if DTM02 is used.


814 ùù 4-22 VERSION 1.0 JUNE 1996

Segment: CUR CurrencyPosition: 050


Usage: OptionalMax Use: 1Purpose: To specify the currency (dollars, pounds, francs, etc.) used in a transaction

Syntax Notes: 1 If CUR08 is present, then CUR07 is required.2 If CUR09 is present, then CUR07 is required.3 If CUR10 is present, then at least one of CUR11 or CUR12 is required.4 If CUR11 is present, then CUR10 is required.5 If CUR12 is present, then CUR10 is required.6 If CUR13 is present, then at least one of CUR14 or CUR15 is required.7 If CUR14 is present, then CUR13 is required.8 If CUR15 is present, then CUR13 is required.9 If CUR16 is present, then at least one of CUR17 or CUR18 is required.10 If CUR17 is present, then CUR16 is required.11 If CUR18 is present, then CUR16 is required.12 If CUR19 is present, then at least one of CUR20 or CUR21 is required.13 If CUR20 is present, then CUR19 is required.14 If CUR21 is present, then CUR19 is required.

Semantic Notes:Comments: 1 See Figures Appendix for examples detailing the use of the CUR segment.

Notes: Currency associated with a service. Not recommended for domestictransactions.


M/U CUR01 98 Entity Identifier Code M ID 2/2Code identifying an organizational entity, a physical location, or anindividual This data element identifies the party using currency defined in theCurrency Code CUR02.

M/U CUR02 100 Currency Code M ID 3/3Code (Standard ISO) for country in whose currency the charges arespecified This data element is a three position alpha code of the ISO-4217.The primary codes used in North America are: MXP - Mexican Peso CAD - Canadian Dollar USD - United States Dollar.

CUR03 280 Exchange Rate O R 4/10Value to be used as a multiplier conversion factor to convert monetaryvalue from one currency to another

CUR04 98 Entity Identifier Code O ID 2/2Code identifying an organizational entity, a physical location, or anindividual

CUR05 100 Currency Code O ID 3/3Code (Standard ISO) for country in whose currency the charges arespecified

CUR06 669 Currency Market/Exchange Code O ID 3/3Code identifying the market upon which the currency exchange rate isbased

X CUR07 374 Date/Time Qualifier X ID 3/3


JUNE 1996 VERSION 1.0 814 ùù 4-23

Code specifying type of date or time, or both date and timeX CUR08 373 Date O DT 6/6

Date (YYMMDD)X CUR09 337 Time O TM 4/8

Time expressed in 24-hour clock time as follows: HHMM, or HHMMSS,or HHMMSSD, or HHMMSSDD, where H = hours (00-23), M = minutes(00-59), S = integer seconds (00-59) and DD = decimal seconds;decimal seconds are expressed as follows: D = tenths (0-9) and DD =hundredths (00-99)














814 ùù 4-24 VERSION 1.0 JUNE 1996

Segment: AMT Monetary AmountPosition: 060


Usage: OptionalMax Use: >1Purpose: To indicate the total monetary amount


Comments:Notes: Amounts related to the service identified in the LIN segment.


M/U AMT01 522 Amount Qualifier Code M ID 1/2Code to qualify amount Valid Value(s):

TP Total payment amountM/U AMT02 782 Monetary Amount M R 1/15

Monetary amount This data element contains the amount of a recurring debit/credit. If the recurring amount is the amount of the current invoice/bill andthe AMT segment is used, the amount specified in this data elementshould be zero.

AMT03 478 Credit/Debit Flag Code O ID 1/1Code indicating whether amount is a credit or debit Valid Value(s):

C CreditD Debit


JUNE 1996 VERSION 1.0 814 ùù 4-25

Segment: PM Electronic Funds Transfer InformationPosition: 070


Usage: OptionalMax Use: 1Purpose: To supply information on the electronic funds transfer (EFT) method of payment

Syntax Notes:Semantic Notes: 1 PM01 is the transit routing number of the receiving financial institution.

2 PM02 is the electronic fund transfer recipient's account number.3 PM03 is the authorization for electronic funds transfer indicator. A "Y" value

indicates authorization has been granted to allow electronic funds transfer;an "N" value indicates no authorization has been granted for electronic fundstransfer.

4 PM04 is the authorization signature for electronic funds transfer on fileindicator. A "Y" value indicates that a signature has been obtained and is onfile; an "N" value indicates a signature has not been obtained.

5 PM05 qualifies the account number indicated in PM02.6 PM06 qualifies the Depository Financial Institution (DFI) Identification

Number indicated in PM01.Comments:

Notes: Electronic Funds Transfer (EFT) information related to the service identified inthe LIN segment. This segment is used for electronic credit or debit services.


M/U PM01 507 (DFI) Identification Number M AN 3/12Depository Financial Institution (DFI) identification number

M/U PM02 508 Account Number M AN 1/35Account number assigned

M/U PM03 1073 Yes/No Condition or Response Code M ID 1/1Code indicating a Yes or No condition or response This data element is the authorization for electronic funds transferindicator. Valid Value(s):

N NoY Yes

M/U PM04 1073 Yes/No Condition or Response Code M ID 1/1Code indicating a Yes or No condition or response This data element is the authorization signature for electronic fundstransfer on file indicator. Valid Value(s)::

N NoY Yes

PM05 569 Account Number Qualifier O ID 1/3Code indicating the type of account This data element qualifies data element 508 in position PM02. Valid Value(s):

DA Demand DepositSG Savings

PM06 506 (DFI) ID Number Qualifier O ID 2/2Code identifying the type of identification number of Depository


814 ùù 4-26 VERSION 1.0 JUNE 1996

Financial Institution (DFI) This data element qualifies data element 507 in position PM01. Valid Value(s):

01 ABA Transit Routing Number Including CheckDigits (9 digits)

02 Swift Identification (8 or 11 characters)03 CHIPS (3 or 4 digits)04 Canadian Bank Branch and Institution Number


JUNE 1996 VERSION 1.0 814 ùù 4-27

Segment: NM1 Individual or Organizational NamePosition: 080

Loop: NM1Level: Detail

Usage: OptionalMax Use: 1Purpose: To supply the full name of an individual or organizational entity

Syntax Notes: 1 If either NM108 or NM109 is present, then the other is required.2 If NM111 is present, then NM110 is required.

Semantic Notes: 1 NM102 qualifies NM103.Comments: 1 NM110 and NM111 further define the type of entity in NM101.

Notes: This NM1 loop contains name/address information for a consumer. If a serviceis related to other individuals or locations, additional NM1 loops should be usedto identify the other individuals or locations.


M/U NM101 98 Entity Identifier Code M ID 2/2Code identifying an organizational entity, a physical location, or anindividual Valid Value(s):

8R Consumer Service Provider (CSP) CustomerBY Buying Party (Purchaser)IL Insured or SubscriberPP Property

M/U NM102 1065 Entity Type Qualifier M ID 1/1Code qualifying the type of entity Values for this data element are confusing and most mechanizedbilling systems do not differentiate between person and non-personaccount names used for billing and payment. Therefore forconsistency, use the following rules: Use '1' (Person), when the entity name is segmented into severalelements: Last (NM103), First (NM104), Middle (NM105), etc. Use '3' (Unknown), when the entity name is not segmented intoseveral elements and the entire name in placed in NM103. Valid Value(s):

1 Person2 Non-Person Entity3 Unknown

NM103 1035 Name Last or Organization Name O AN 1/35Individual last name or organizational name

NM104 1036 Name First O AN 1/25Individual first name

NM105 1037 Name Middle O AN 1/25Individual middle name or initial

NM106 1038 Name Prefix O AN 1/10Prefix to individual name

NM107 1039 Name Suffix O AN 1/10Suffix to individual name

NM108 66 Identification Code Qualifier X ID 1/2


814 ùù 4-28 VERSION 1.0 JUNE 1996

Code designating the system/method of code structure used forIdentification Code (67) Valid Value(s):

92 Assigned by Buyer or Buyer's AgentNM109 67 Identification Code X AN 2/20

Code identifying a party or other codeNM110 706 Entity Relationship Code X ID 2/2

Code describing entity relationshipNM111 98 Entity Identifier Code O ID 2/2

Code identifying an organizational entity, a physical location, or anindividual


JUNE 1996 VERSION 1.0 814 ùù 4-29

Segment: N2 Additional Name InformationPosition: 090


Usage: OptionalMax Use: 2Purpose: To specify additional names or those longer than 35 characters in length


Comments:Notes: Additional name information for a consumer or other individual related to the

consumer service.


M/U N201 93 Name M AN 1/35Free-form name

N202 93 Name O AN 1/35Free-form name


814 ùù 4-30 VERSION 1.0 JUNE 1996

Segment: N3 Address InformationPosition: 100


Usage: OptionalMax Use: 2Purpose: To specify the location of the named party


Comments:Notes: Address information for a consumer, other individual or location related to the

consumer service.


M/U N301 166 Address Information M AN 1/35Address information

N302 166 Address Information O AN 1/35Address information


JUNE 1996 VERSION 1.0 814 ùù 4-31

Segment: N4 Geographic LocationPosition: 110


Usage: OptionalMax Use: 1Purpose: To specify the geographic place of the named party

Syntax Notes: 1 If N406 is present, then N405 is required.Semantic Notes:

Comments: 1 A combination of either N401 through N404, or N405 and N406 may beadequate to specify a location.

2 N402 is required only if city name (N401) is in the U.S. or Canada.Notes: Address geographic location information for a consumer, other individual or

location related to the consumer service.


N401 19 City Name O AN 2/30Free-form text for city name

N402 156 State or Province Code O ID 2/2Code (Standard State/Province) as defined by appropriate governmentagency

N403 116 Postal Code O ID 3/15Code defining international postal zone code excluding punctuation andblanks (zip code for United States)

N404 26 Country Code O ID 2/3Code identifying the country

N405 309 Location Qualifier X ID 1/2Code identifying type of location

N406 310 Location Identifier O AN 1/30Code which identifies a specific location


814 ùù 4-32 VERSION 1.0 JUNE 1996

Segment: PER Administrative Communications ContactPosition: 120


Usage: OptionalMax Use: >1Purpose: To identify a person or office to whom administrative communications should be

directedSyntax Notes: 1 If either PER03 or PER04 is present, then the other is required.

2 If either PER05 or PER06 is present, then the other is required.3 If either PER07 or PER08 is present, then the other is required.


Notes: Consumer, other individual or location information contacts and telephonenumbers.


M/U PER01 366 Contact Function Code M ID 2/2Code identifying the major duty or responsibility of the person or groupnamed Valid Value(s):

IC Information ContactPER02 93 Name O AN 1/35

Free-form namePER03 365 Communication Number Qualifier X ID 2/2

Code identifying the type of communication number Valid Value(s):

TE TelephonePER04 364 Communication Number X AN 1/80

Complete communications number including country or area codewhen applicable





X PER09 443 Contact Inquiry Reference O AN 1/20Additional reference number or description to clarify a contact number


JUNE 1996 VERSION 1.0 814 ùù 4-33






Notes: Reference numbers related to a consumer, other individuals or location.


M/U REF01 128 Reference Identification Qualifier M ID 2/3Code Qualifying the Reference Identification Valid Value(s):

SY Social Security NumberREF02 127 Reference Identification X AN 1/30

Reference information as defined for a particular Transaction Set or asspecified by the Reference Identification Qualifier










814 ùù 4-34 VERSION 1.0 JUNE 1996






Notes: Dates related to a consumer, other individuals or location.


M/U DTM01 374 Date/Time Qualifier M ID 3/3Code specifying type of date or time, or both date and time





X DTM06 1250 Date Time Period Format Qualifier X ID 2/3Code indicating the date format, time format, or date and time format

X DTM07 1251 Date Time Period X AN 1/35Expression of a date, a time, or range of dates, times or dates andtimes


JUNE 1996 VERSION 1.0 814 ùù 4-35

Segment: SE Transaction Set TrailerPosition: 010

Loop:Level: Summary

Usage: MandatoryMax Use: 1Purpose: To indicate the end of the transaction set and provide the count of the

transmitted segments (including the beginning (ST) and ending (SE) segments)Syntax Notes:

Semantic Notes:Comments: 1 SE is the last segment of each transaction set.


M/U SE01 96 Number of Included Segments M N0 1/10Total number of segments included in a transaction set including STand SE segments

M/U SE02 329 Transaction Set Control Number M AN 4/9Identifying control number that must be unique within the transactionset functional group assigned by the originator for a transaction set

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