Compliance Continued
- Details
- Category: Pace + Health Solutions
- Published on Friday, 17 June 2011 16:55
- Written by Administrator
- Hits: 322
| Transaction/Forms EDI Definition Table | |
| Transaction | Definition |
| 270/271 | The X12 Health Care Eligibility & Benefit Inquiry transaction (270) and Response transaction (271). |
| 276/277 | The X12 Claim Status Request (276) and Status Notification (277). |
| 834 |
The X12 Benefit Enrollment & Maintenance transaction. |
| 835 |
The X12 Health Care Claim Payment & Remittance Advice transaction. |
| 837 |
The X12 Health Care Claim or Encounter transaction. This transaction can be used for institutional, professional, dental, or drug claims. |
CMS 1500 |
CMS 1500 (formerly Health Care Financing Administration (HCFA 1500)) professional uniform claim form. Also known as the UCF-1500. |
| UB04 |
A uniform institutional claim form developed by the National Uniform Billing Committee (NUBC)(formerly UB92). |
| NCPDP |
National Council for Prescription Drug Programs(NCPDP): An ANSI-accredited group that maintains a number of standard formats for use by the retail pharmacy industry, some of which are included in the HIPAA mandates. |