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Back   Health Care Predetermination: Professional (005010X291)

Purpose

The Health Care Predetermination: Professional Implementation Guide describes the use of the ANSI ASC X12 Health Care Claim (837) transaction set for the submission and transfer of professional predeterminations to health care payers and clearinghouses.

Primary Trading Partners

Trading partners include:
  • Health care providers, such as, physicians, hospitals, and suppliers
  • Health care payers, such as, private health care insurers and HMO's, clearinghouses, repricers, VANs, etc.

References

This is the first implementation guide for this business purpose.

Additional Information

Registered 1/29/2009 Published 2/1/2010
Transaction Set ID 837 Standard Version 005010
ASC X12 DM# 039209 Owning Group X12N/TG2/WG2