Search results
Results from the WOW.Com Content Network
The X12 834 EDI Enrollment Implementation Format is a standard file format in the United States for electronically exchanging health plan enrollment data between employers and health insurance carriers.
In July 1992, WEDI published a report that outlined the steps necessary to make electronic data interchange (EDI) a routine business practice for the health care industry by 1996. The Workgroup envisioned the entire health care industry transacting business electronically, under a nationwide set of coding and format standards for all transactions.
The Accredited Standards Committee X12 (also known as ASC X12) is a standards organization.Chartered by the American National Standards Institute (ANSI) in 1979, [2] it develops and maintains the X12 Electronic data interchange (EDI) and Context Inspired Component Architecture (CICA) standards along with XML schemas which drive business processes globally.
An explanation of benefits (commonly referred to as an EOB form) is a statement sent by a health insurance company to covered individuals explaining what medical treatments and/or services were paid for on their behalf. [1] The EOB is commonly attached to a check or statement of electronic payment. An EOB typically describes:
Underwriting Information Services 256 Periodic Compensation 267 Individual Life, Annuity and Disability Application 268 Annuity Activity 269 Health Care Benefit Coordination Verification 270 Eligibility, Coverage or Benefit Inquiry 271 Eligibility, Coverage or Benefit Information 272 Property and Casualty Loss Notification 273
Electronic data interchange (EDI) is the concept of businesses electronically communicating information that was traditionally communicated on paper, such as purchase orders, advance ship notices, and invoices. Technical standards for EDI exist to facilitate parties transacting such instruments without having to make special arrangements.
An electronic remittance advice (ERA) is an electronic data interchange (EDI) version of a medical insurance payment explanation. It provides details about providers' claims payment, and if the claims are denied, it would then contain the required explanations. The explanations include the denial codes and the descriptions, which present at the ...
EDI Health Care Service Review Information (278) is a transaction set that can be used to transmit health care service information, such as subscriber, patient, demographic, diagnosis or treatment data for the purpose of the request for review, certification, notification or reporting the outcome of a health care services review. EDI Functional ...