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Back   Health Care Claim Payment/Advice (006020X258)

Purpose

The Health Care Claim Payment/Advice Implementation Guide describes the use of the ANSI ASC X12 Health Care Claim Payment/Advice (835) transaction set for the following business usages:
  • Make payment on a health care claim
  • Send an Explanation of Benefits (EOB) remittance advice
  • Make payment and send an EOB in the same transaction

Primary Trading Partners

Health care providers such as hospitals and physicians; health care payers such as insurance companies, PPOs, HMOs, and state and federal agencies.

Exceptions/Limitations

Intended use is for health care remittance advice/payment. It is not intended for non-health care use.

References

  • Health Care Claim Payment/Advice (003051X000)
  • Health Care Claim Payment/Advice (003070X052)
  • Health Care Claim Payment/Advice (004010X091)
  • Health Care Claim Payment/Advice (004050X124)
  • Health Care Claim Payment/Advice (005010X221)
  • Health Care Claim Payment/Advice (005030X239)

Coordination

  • ANSI ASC X12N Health Care Claim Payment Workgroup (TG2/WG3)
  • ANSI ASC X12N Health Care Claims Workgroup (TG2/WG2)
  • Subcommittees sharing the DM: X12F, X12N

Additional Information

Registered 9/27/2006
Transaction Set ID 835 Standard Version 006020
ASC X12 DM# Owning Group X12N/TG2/WG3/835