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Back   Health Care Claim Request for Additional Information (006020X313)

Purpose

The Health Care Claim Request for Additional Information Implementation Guide describes the use of the ASC X12 Health Care Claim Status Notification (277) transaction set to request additional information to support a health care claim or encounter.

Primary Trading Partners

  • Health care providers, such as physicians, medical groups, dentists, hospitals, pharmacies, suppliers, etc.
  • Health care payers, such as insurance companies, third party administrators, state and federal agencies, etc.
  • Clearinghouses, billing services, VANS, etc.

Exceptions/Limitations

Requests for additional information related to prior authorization.

References

  • Health Care Claim Request for Additional Information (003070X071)
  • Health Care Claim Request for Additional Information (004020X104)
  • Health Care Claim Request for Additional Information (004050X150)
  • Health Care Claim Request for Additional Information (004060X190)
  • Health Care Claim Request for Additional Information (005010X213)
  • Health Care Claim Request for Additional Information (006020X268)

Coordination

  • ASC X12N TG2/WG2 (Health Care Claims
  • ASC X12N TG2/WG3 (Health Care Claim Payment
  • ASC X12N TG2/WG9 (Patient Information & Attachments

Additional Information

Registered 9/24/2013 Published 9/25/2014
Transaction Set ID 277 Standard Version 006020
ASC X12 DM# Owning Group X12N/TGC/WG3