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Back   Medical Stop Loss Industry -- Premium Payments & Adjustments (003070X084)

Purpose

The Medical Stop Loss Industry -- Premium Payments & Adjustments Implementation Guide describes the use of the ANSI ASC X12 Payment Order/Remittance Advice (820) transaction set, version 3070, for the following business usage:
  • To provide corporate premium payments, premium adjustments, and associated remittance information between self-funded, health plan administrators and their Insurance Stop Loss carriers (Excess Risk Insurers) or their intermediaries

Primary Trading Partners

Employer groups, producers (TPAs, brokers, consultants), managing general underwriters, and insurance carriers.

Exceptions/Limitations

Does not support insurance claim payments.

References

This is the first implementation guide for this business purpose.

Coordination

ANSI ASC X12 Insurance Subcommittee's SPTG1 (Insurance Billing and Collections).

Additional Information

Registered 5/1/1997
Transaction Set ID 820 Standard Version 003070
ASC X12 DM# Owning Group X12N