What is EDI 278 transaction?
The EDI 278 transaction set is called Health Care Services Review Information. A healthcare provider, such as a hospital, will send a 278 transaction to request an authorization from a payer, such as an insurance company.
What is a 275 EDI transaction?
EDI 275 Specification This transaction set can be used to communicate individual patient information requests and patient information (either solicited or unsolicited) between separate health care entities in a variety of settings to be consistent with confidentiality and use requirements.
What is a 270 271 transaction?
The 270 transaction is the EDI function that requests eligibility and benefit information from the Insurance Company of the patient. It is set to receive care from a Provider of Service. The 271 transaction is the EDI function that responds eligibility and benefit information of the patient.
What are 835 and 837 transactions?
When a healthcare service provider submits an 837 Health Care Claim, the insurance plan uses the 835 to help detail the payment to that claim. The 837-transaction set is the electronic submission of healthcare claim information.
What is a 270 transaction?
The 270 Transaction Set is used to transmit Health Care Eligibility Benefit Inquiries from health care providers, insurers, clearinghouses and other health care adjudication processors. The 270 Transaction Set can be used to make an inquiry about the Medicare eligibility of an individual.
What are 276 files?
The EDI 276 transaction set is a Health Care Claim Status Inquiry. It is used by healthcare providers to verify the status of a claim submitted previously to a payer, such as an insurance company, HMO, government agency like Medicare or Medicaid, etc.
What is a 275 file?
Electronic Attachments (275 transactions) are supplemental documents providing additional patient medical information to the payer that cannot be accommodated within the ANSI ASC X12, 837 claim format.
What is EDI format?
Electronic Data Interchange (EDI) is the electronic interchange of business information using a standardized format; a process which allows one company to send information to another company electronically rather than with paper.
What is an 855 file?
What is an EDI 855? An EDI 855 Purchase Order Acknowledgement is an EDI transaction set normally sent by a seller to a buyer in response to an EDI 850 Purchase Order. In addition to confirming the receipt of a new order, the document tells the buyer if the purchase order was accepted, required changes, or was rejected.