HIPAA 271 Premium Grace Period Notification: Determining Transaction Compliance with Industry Usage Requirements
HIPAA 271 Premium Grace Period Notification transmitted transaction complies with the governing implementation guide when it satisfies the requirements as defined within the implementation guide. Specifically, the presence or absence of an item (loop, segment, or element) complies with the industry usage specified by this implementation guide according to the following table:
Loop requirements depend on the context or location of the loop within the transaction.
- A nested loop can be used only when the associated higher level loop is used.
- The usage of a loop is the same as the usage of its beginning segment.
- If a loop’s beginning segment is Required, the loop is Required and must occur at least once unless it is nested in a loop that is not being used.
- If a loop’s beginning segment is Situational, the loop is Situational.
- Subsequent segments within a loop can be sent only when the beginning segment is used.
- Required segments in Situational loops occur only when the loop is used.
Transaction Set Sections Listing
When working with transaction implementation guides pay attention to the sections mentioned below. Each section gives a certain type of information.
Implementation: This section lists the levels, loops, and segments contained in this implementation. It also serves as an index to the segment detail.
X12 Standard: This section is included as a reference. The implementation guide reference clarifies actual usage.
271 – Segment Detail: This section specifies the segments, data elements, and codes for this implementation.
Industry Names: This section contains an alphabetic listing of industry-specific names and definitions attributed to X12 generic data elements and used in this implementation guide. Data element names in normal type are generic ASC X12 names. Italic type indicates an industry defined name. Consult the appropriate X12N Data Element Dictionary, available for purchase at the ASC X12 online store, for a complete list of all X12N Industry Names.