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Back   Health Care Provider Inquiry and Information Response (004050X185)

Purpose

The Health Care Provider Inquiry and Information Response Implementation Guide describes the use of the Healthcare Provider Information (274) version/release 4050 Transaction Set following business usage:
  • Obtain a listing of available providers from an Information Source organization, such as an insurance company based upon search criteria.

Primary Trading Partners

Trading partners include:
  • Health care providers, such as hospitals and physicians
  • Health care payers, such as insurance companies, HMOs, PPOs
  • State and federal agencies, such as Medicare, Medicaid, and CHAMPUS
  • Other entities such as professional organizations, licensing agencies, regulatory agencies, and group health customers

Exceptions/Limitations

Intended for use as a subset of a provider network. Does not provide a full provider directory.

References

This is the first implementation guide for this business purpose.

Additional Information

Registered 2/6/2003
Transaction Set ID 274 Standard Version 004050
ASC X12 DM# Owning Group X12N/TG2/WG15