Back   Unsolicited Health Care Eligibility/Benefit Roster (004010X040)


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 3070 transaction set for the unsolicited request for the following roster types:
  • Capitation payment detail
  • Membership list
  • Plan (coverages)
  • Group (employer)
  • Provider

Primary Trading Partners

Health care providers, such as hospitals and physicians. Health Care payers, such as insurance companies, HMOs, PPOs, and state and federal agencies.


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


This is the first implementation guide for this business purpose.


ASC X12 Insurance Subcommittee's Health Care Task Group's WG4 and WG15. ASC X12N Property & Casualty Task Group's Claim Work Group (TG1/WG2) and Workers' Compensation/Disability Work Group (TG1/WG3).

Additional Information

Registered 4/27/1996 Published 3/3/2006
Transaction Set ID 271 Standard Version 004010
ASC X12 DM# Owning Group X12N/TG2/WG1