1. Referral request - data classification Patient information – Patient demographics, covered by MU2 and CCDA requirements – Patient identifier (Med Rec Number) As known to the sender Common for both sender and receiver As known to the receiver – Two elements from spreadsheed don’t belong SSN should not be used for healthcare Medicare # - this is administrative information, belongs to insurance information

2. Referral request - data classification Referral administrative information – Referral Identifier (not present in the spreadsheet) – Referral Date – Referral Approval obtained – Insurance information (multiple insurance policies/kinds possible) – usually covered in ADT or X12 messages Kind (primary, secondary, Medicare/Medicaid, Worker’s comp) Policy number Group number Insurance member ID (e.g. Medicare #) Guarantor/Subscriber/Insured demographics

3. Referral request - data classification Referring provider (sender) information Receiving provider information Patient’s PCP (if different from sender and receiver) – Information provided by provider directories Provider identifier – Direct address – NPI # Provider demographics Provider organization

4. Referral request - data classification Clinical information – Reason for referral – MU2 specified clinical information Problems Medications Allergies Relevant lab results – Additional clinical information (depending on specialty)