HIPAA Standard 270/271 Eligibility Transactions (HealthNet)

EDI trainingRequests for eligibility status for a single commercial, Medicare or state health programs member transaction may be submitted by registered participating providers on the Health Net provider website. Select the appropriate Verify Eligibility link under Eligibility & Benefits to the left to get started.

To request eligibility and obtain eligibility information for multiple members at one time, providers can use the 270/271 eligibility transaction through one of two electronic clearinghouses. A 270 request provides eligibility verification information directly to providers through a real-time link. Providers submit a request for a single HIPAA standard 270 or multiple 270s and obtain the 271 responses from Health Net online.

271 responses are also compliant with the Council for Affordable Quality Healthcare (CAQH®)/Committee on Operating Rules for Information Exchange (CORE™) Phase II requirements.

In accordance with the Health Insurance Portability and Accountability Act (HIPAA) privacy requirements for submission of electronic health care transactions, Health Net is compliant in meeting and adopting the 270/271 eligibility transaction standards as outlined by HIPAA and with the Administration Simplication Operating rules for eligibility and health care claim status transactions. Check with your vendor/clearinghouse for sending/receiving eligibility requests using the 270/271 real time transaction or contact one of the Health Net clearinghouses listed below to set up the HIPAA standard 270 request.

To learn more about 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Your email address will not be published.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