What is a 274 file?
EDI 274 is an electronic document used to transmit demographic and educational/professional qualifications about healthcare providers. This transaction set is mainly used for one of the following purposes: Maintain a provider database. Submit an application for joining a provider or health maintenance organization.
What is X12 274?
EDI 274 Specification This X12 Transaction Set contains the format and establishes the data contents of the Healthcare Provider Information Transaction Set (274) for use within the context of an Electronic Data Interchange (EDI) environment.
What is a 278 EDI 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 transaction?
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 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 is a 837 transaction?
The 837-transaction set is the electronic submission of healthcare claim information. Healthcare service providers are required to be compliant with HIPAA EDI standards when submitting medical claims to payers in electronic format.
What is a Hipaa 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 is 837P and 837i?
The 837i is the electronic version of the paper form UB-04. 837i files are used to transmit institutional claims. Institutional claims are those submitted by hospitals and skilled nursing facilities. The 837p is the electronic version of the CMS-1500 form. 837p files are used to transmit professional claims.
What is the 274 expansion project?
The purpose of the 274 Expansion Project is to implement a comprehensive and standardized file layout and protocol for DHCS health plans to submit provider network data to DHCS. The data will be used by DHCS for network assessments, data analytics, and other federal and state reporting requirements.
What is Edi 274 format?
EDI 274 Specification. This X12 Transaction Set contains the format and establishes the data contents of the Healthcare Provider Information Transaction Set (274) for use within the context of an Electronic Data Interchange (EDI) environment.
Can I plug my 274 transaction into my ERP or TMS?
Or perhaps you would like to use a Cloud-Based application, so you can plug your 274 transaction directly into your ERP and TMS systems. Even small companies have the ability to trade the EDI 274 by using the EDI Mobile Device solution.