F12 Basic Claim Information - Automotive

To provide information for automotive claims

Position
Element
Name
Type
Requirement
Min
Max
Repeat
F12-01
Reference Number
String (AN)
Mandatory
1
30
-
Reference number or identification number as defined for a particular Transaction Set, or as specified by the Reference Number Qualifier. Also see Reference Number Qualifier, (128).
F1201 is used for Dealer's Repair Order Number.
F12-02
Reference Number
String (AN)
Mandatory
1
30
-
Reference number or identification number as defined for a particular Transaction Set, or as specified by the Reference Number Qualifier. Also see Reference Number Qualifier, (128).
F1202 is used for Dealer's Document Number.
F12-03
Date
Date (DT)
Mandatory
6
6
-
Date (YYMMDD).
F1203 is used for Repair Order Date.
F12-04
Credit Memo/Debit Memo Number
String (AN)
Mandatory
1
16
-
Number assigned by issuer of a credit or debit memo.
F12-05
Credit Memo/Debit Memo Date
Date (DT)
Mandatory
6
6
-
Date on which credit memo or debit memo was issued or made effective.
F12-06
Labor Rate
N2
Mandatory
3
4
-
The labor/time guide rate used by the division to reimburse the dealer for repair work.
F1206 is used for Body Repair Rate.
F12-07
Labor Rate
N2
Mandatory
3
4
-
The labor/time guide rate used by the division to reimburse the dealer for repair work.
F1207 is used for Chassis Repair Rate.

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