This resource provides the request and response details for the request for which all actions are to be reversed or terminated.

The Response Business Identifier.

The version of the style of resource contents. This should be mapped to the allowable profiles for this and supporting resources.

The style (standard) and version of the original material which was converted into this resource.

Knowledge of the original version can inform the processing of this instance so that information which is processable by the originating system may be generated.

The date when this resource was created.

The Insurer who is target of the request.

The practitioner who is responsible for the services rendered to the patient.

The organization which is responsible for the services rendered to the patient.

Reference of resource to reverse.

Reference of response to resource to reverse.

Payee information supplied for matching purposes.

Party to be reimbursed: Subscriber, provider, other.

The provider who is to be reimbursed for the claim (the party to whom any benefit is assigned).

The organization who is to be reimbursed for the claim (the party to whom any benefit is assigned).

The person other than the subscriber who is to be reimbursed for the claim (the party to whom any benefit is assigned).

Financial instrument by which payment information for health care.

Health care programs and insurers are significant payors of health service costs.

A service line item.

To maintain order of the coverages.

The instance number of the Coverage which is the focus for adjudication, that is the Coverage to which the claim is to be adjudicated against.

To identify which coverage is being adjudicated.

Reference to the program or plan identification, underwriter or payor.

Need to identify the issuer to target for processing and for coordination of benefit processing.

The contract number of a business agreement which describes the terms and conditions.

The relationship of the patient to the subscriber.

To determine relationship between the patient and the subscriber.

If true remove all history excluding audit.

Some resources must not simple be reversed in a processing or accounting sense but rather must have all history removed, such as the accidental submission of sensitive and/or wrong information. If the receiver cannot comply with a Nullify request then they must reject the request.