Public Review Period

Announcing a Public Review Period for four X12 837 Implementation Guides, X323, X324, X325 and X326

The following four implementation guides will be available for public review beginning October 15, 2019. The review period will close November 30, 2019 at 8:00 PM, Eastern Time. These guides have been developed by X12’s Insurance subcommittee based on version 007030 of the X12 Standard.

Following this review period, X12 will conduct a corresponding Informational Forum. The Informational Forum is the final opportunity for public discussion of the review comments and resulting revisions.

  • The Health Care Claim: Professional Implementation Guide (007030X323) describes the use of the ASC X12 Health Care Claim (837) transaction set to submit and transfer professional claims and encounters to primary, secondary, and subsequent payers.
  • The Health Care Claim: Institutional Implementation Guide (007030X324) describes the use of the X12 Health Care Claim (837) transaction set to submit and transfer institutional claims and encounters to primary, secondary, and subsequent payers.
  • The Health Care Claim: Dental Implementation Guide (007030X325) describes the use of the X12 Health Care Claim (837) transaction set to submit and transfer dental claims and encounters to primary, secondary, and subsequent payers.
  • The Health Care Service: Data Reporting Implementation Guide (007030X326) describes the use of the X12 Health Care Claim (837) transaction set for the following business usages:
    • Reporting health care service data for use in health data statistical analysis from provider data
    • Reporting health care service data to satisfy governmental mandates necessary to regulate the health care industry
    • Reporting health care service data to measure utilization rates.

The draft implementation guide will be available in an on-line forum at forums.x12.org. The draft information is provided for public review and cannot be used for any other purpose without permission from X12. Reviewers may submit comments on the draft via the on-line forum. Instructions for reviewing the pages and submitting comments are posted on the forums page.

Interested parties may monitor all submitted comments and the associated responses via the on-line forum during the public review period and prior to the Informational Forum. Watch for the announcement of the corresponding Informational Forum.

To learn more about Health Care EDI and become a certified  EDI Professional please visit our course schedule page.

Leave a Reply

Your email address will not be published.

Post Navigation