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Back   Additional Payer Health Care Information (005040X254)

Purpose

The Additional Payer Health Care Information Implementation Guide describes the use of the Patient Information (275) Version/Release 005040 Transaction Set to send various types of health care information related to a health care event or the subsequent processes associated with that event including, but not limited to the following business usages:
  • Medical Bills
  • Explanation of Policy Benefits
  • Explanation of Bill Reviews
  • Letters and correspondence
  • Medical service support documents
  • Assignment and authorization forms
  • Legislatively mandated forms and documents

Primary Trading Partners

Trading partners include, but are not limited to:
  • Hospitals
  • Physicians
  • Health care payers, such as insurance companies, HMOs, and PPOs
  • State and Federal programs, such as Medicare, Medicaid, and TRICARE (CHAMPUS)
  • Attorneys

References

This is the first implementation for this business purpose.

Coordination

Health Level Seven

Additional Information

Registered 6/8/2005
Transaction Set ID 275 Standard Version 005040
ASC X12 DM# 044305 Owning Group X12N/TG2