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Back   Unsolicited Health Care Eligibility/Benefit Roster (006020X296)

Purpose

The Unsolicited Health Care Eligibility/Benefit Roster Implementation Guide describes the use of the ANSI ASC X12 Eligibility, Coverage or Benefit Information (271) Version/Release 005010 transaction set for the unsolicited request for the following roster types:
  • Capitation payment detail
  • Membership list
  • Plan (coverages)
  • Group (employer)
  • Provider

Primary Trading Partners

Trading partners include:
  • Health care providers, such as hospitals and physicians.
  • Health Care payers, such as insurance companies, HMOs, PPOs, and state and federal agencies.

Exceptions/Limitations

This implementation guide is not intended for use within the property & casualty industry.

References

  • Unsolicited Health Care Eligibility/Benefit Roster (000010X040)
  • Unsolicited Health Care Eligibility/Benefit Roster (005010X205)

Additional Information

Registered 10/2/2011
Transaction Set ID 271 Standard Version 006020
ASC X12 DM# Owning Group X12N/TG2/WG1