Registry



Back   Additional Information to Support a Health Care Claim or Encounter (006020X275)

Purpose

The Additional Information to Support a Health Care Claim or Encounter Implementation Guide describes the use of the ASC X12 Patient Information (275) transaction set for the following business usage:
  • To assist those who send additional supporting information or who receive additional supporting information to a health care claim or encounter.

Primary Trading Partners

Entities that use this implementation of the 275 include, but are not limited to:
  • Providers
  • Health Plans
  • Third Party Administrators (TPA)
  • Managed Care Service Organizations, State and Federal Agencies and their contractors
  • and any other entity that processes health care claims, manages the delivery of health care services, or collects health care data.
Other business partners affiliated with with the 275 include, but are not limited to:
  • Billing Services
  • Consulting Services
  • Vendors of Systems Software and EDI translators, and EDI network intermediaries such as authomated clearing houses (ACHs), value added networks (VANs), and telecommunications services.

References

  • Additional Information to Support a Health Care Claim or Encounter (004020X107)
  • Additional Information to Support a Health Care Claim or Encounter (004050X151)
  • Additional Information to Support a Health Care Claim or Encounter (004060X195)
  • Additional Information to Support a Health Care Claim or Encounter (005010X210)

Coordination

ASC X12N/TG2/WG5 - The solicited model for attachments includes a paired transaction with the 277 Health Care Claim Request for Additional Information. Coordination will occur with WG5 to ensure synchronization of these two Implementation Guides.

ASC X12N/TG2/WG2 - The unsolicited model for attachments includes the need for coordination with the 837 Health Care Claim Transactions. Coordination will occur with WG2 to ensure the appropriate synchronization with these claim Implementation Guides.

Health Level Seven (HL7) - This implementation guide describes a solution that includes the encapsulation of the Health Level Seven (HL7) Clinical Document Architecture (CDA) Standard within the binary segment to support the exchange of the additional information needed to support a health care claim or encounter.

Additional Information

Registered 6/2/2007 Published 9/25/2014
Transaction Set ID 275 Standard Version 006020
ASC X12 DM# Owning Group X12N/TG2/WG9/275CE