275 X211 HIPAA

275 X211 – Patient Information: Definition and Usage

The 275 X211 – Patient Information transaction is a standardized electronic document used for exchanging patient information between healthcare providers, payers, and other entities involved in the healthcare industry via EDI. This transaction set is part of the ANSI X12 EDI standards, which are widely used in the United States for healthcare transactions.

The purpose of the 275 X211 transaction is to convey detailed patient information, including demographics, medical history, insurance coverage, and any other relevant data necessary for the provision of healthcare services. This information exchange facilitates efficient communication and coordination among different stakeholders within the healthcare ecosystem.

Key components typically included in a 275 X211 transaction may encompass:

  1. Patient demographics: Name, address, date of birth, gender, etc.
  2. Insurance information: Policy number, coverage details, payer information, etc.
  3. Medical history: Diagnosis codes, treatment history, medications prescribed, allergies, etc.
  4. Provider information: Identifying details of the healthcare provider(s) involved in the patient’s care.
  5. Authorization details: Any authorizations or referrals related to the patient’s care.

By employing standardized electronic formats like the 275 X211 transaction, healthcare organizations can enhance interoperability, ensure data accuracy, and ultimately provide better care to patients. Additionally, it helps in complying with regulatory requirements such as HIPAA (Health Insurance Portability and Accountability Act) by securely transmitting sensitive patient information.

To learn more about Healthcare EDI and become a CEDIAP® (Certified EDI Academy Professional), please visit our course schedule page.

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