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Back   Health Care Services Review Inquiry/Response (007030X327)

Purpose

The Health Care Services Review Inquiry and Response Implementation Guide describes the use of the ASC X12 Health Care Services Review Information (278) transaction set for the following business usages:
  • Make inquiries to utilization management organizations for information on previously processed health care services
  • Send response(s) to inquiry(ies) on previously processed health care services

Primary Trading Partners

Trading partners include:
  • Health care providers, such as hospitals, physicians, medical groups, independent physician associations, and facilities
  • Health care review entities, such as insurance companies, HMOs, PPOs, health care purchasers, professional review organizations, and other utilization review organizations

References

  • Health Care Services Review Inquiry/Response (004010X059)
  • Health Care Services Review Inquiry/Response (005010X215)
  • Health Care Services Review Inquiry/Response (006020X264)

Coordination

No coordination required at this time with other ASC X12 groups.

Additional Information

Registered 9/8/2015
Transaction Set ID 278 Standard Version 007030
ASC X12 DM# Owning Group X12N/TGB