Health Care Provider Inquiry and Information Response (005030X209)

Purpose

The Health Care Provider Inquiry and Information Response Guide describes the use of the Healthcare Provider Information (274) Version/Release 005010 for the following business usages:

Obtain a listing of available providers from an Information Source Organization, such as an insurance company, based upon search criteria.

Primary Trading Partners

Trading partners include, but are not limited to:

Health care providers, such as hospitals and physicians
Health care payers, such as insurance companies, HMOs, and PPOs, and state and federal agencies, such as Medicare, Medicaid, and CHAMPUS

Exceptions/Limitations

Limited to use as a subset of a provider network. Does not provide a full provider directory.

References

Health Care Provider Inquiry and Information Response (004050X185)

Additional Information