F12 Basic Claim Information - Automotive

To provide information for automotive claims

Position
Element
Name
Type
Requirement
Min
Max
Repeat
F12-01
Reference Identification
String (AN)
Mandatory
1
30
-
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
F1201 is used for dealer's repair order number.
F12-02
Reference Identification
String (AN)
Mandatory
1
30
-
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
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/Debit Adjustment Number
String (AN)
Mandatory
1
16
-
Number assigned by issuer of a credit or debit memo
F1204 and F1205 will be used if sublet services are reported.
F12-05
Date
Date (DT)
Mandatory
6
6
-
Date (YYMMDD)
F1205 contains the debit/credit memo date.
F12-06
Labor Rate
N2
Mandatory
3
6
-
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
6
-
The labor/time guide rate used by the division to reimburse the dealer for repair work
F1207 is used for chassis repair rate.
F12-08
Damage Code Qualifier
Identifier (ID)
Optional
1
1
-
Code identifying the party maintaining damage area, damage type and damage severity code lists

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