278 EDI Transaction (Response) example – raw data and human readable In our previous posts we have already spoke about 278 EDI Transaction. We mentioned definition and purposes of the 278 EDI Transaction and reviewed 278 EDI Transaction (Request) example. The following is a turn-around from the previous 278 EDI Transaction request. The HRC segment authorizes … Read More →
278 Health Care Services Review Information – definition and purpose The 278 Health Care Services Review Information transaction belongs to HIPAA EDI documents. A health organization can send 278 Health Care Services Review Information (patient data, diagnosis or treatment data) for the purposes of requesting a review. Typically the requestor (the sending party) is the … Read More →
HIPAA EDI 835 transaction and balancing formula description The HIPAA EDI 835 example given in the post is for two institutional claims. It is a remittance advice and it’s submitted by BCBS DISNEY (payer) to UCLA MEDICAL CENTER (payee). BPR-01 = “I” which means “Remittance Advice Only” The payment is for patient Mickey Mouse and Donald … Read More →
820 Payment Order / Remittance Advice (RA) definition and important notes The 820 Payment Order / Remittance Advice can be used in three ways: (1) It can be used as a remittance advice to describe detailed information about a payment. (2) It can be used to authorize financial institutions to electronically transfer funds (EFT) from … Read More →