ASC X12 Technical Report Newsletter Header

PUBLICATION ANNOUNCEMENT

005050X229: Automobile Property Record Change Notification

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The Automobile Property Record Change Notification Type 3 Technical Report describes the use of the ASC X12 Mortgage Record Change (266) transaction set and the ASC X12 Application Advice (824) transaction set for the following business usages:

  • Notification of changes in financial interest on auto property records
  • Notification of auto property record change errors

Intended only for use in notifying insurers of changes in financial interest on an auto property loan or lease, 005010X229 is available for purchase here:
www.wpc-edi.com/x229 Opens in New Window

Versatile Suite of TR3s Report Health Care Claim Status

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ASC X12's 277 Health Care Information Status Notification transaction set can, among other functions, be used to transmit claim status information for a health care claim. This claim status information is generally provided after a payer's successful receipt of an ASC X12 837 transaction and before the transmission of an ASC X12 835 payment/advice transaction. The 277 in this mode is useful for providers tracking progress towards claim days-receivables-outstanding or prompt payment deadlines.

ASC X12's Insurance Subcommittee has published a suite of technical reports describing specific business usages of the generic 277 transaction set for reporting claim status. The power and flexibility of the 277 suite described below can be seen in the vocabulary of its action and reason code lists: Claim Status Category Codes Opens in New Window and Claim Status Codes Opens in New Window. The lists are updated three times a year, and are used across, and independent of, TR3 versions.

The following three 005010 TR3s are especially useful for tracking the status of health care claims:

005010X212        

Health Care Claim Status Request and Response
By virtue of being adopted under HIPAA, 005010X212 is probably the most well-known of the 277-based TR3s. This TR3 pairs a 276 Health Care Claim Status Request with a 277 response; creating a back-and-forth, on-demand, interaction between providers and payers. Typically, the 277 response reports a claim's adjudication status. 005010X212 is available for purchase individually or in a package with all of the HIPAA-mandated TR3s here:
http://store.x12.org Opens in New Window

005010X214

Health Care Claim Acknowledgment
Next well-known is 005010X214. This TR3 is used by payers to acknowledge general receipt of claims along with various accepted and rejected claim totals. Additionally, 005010X214-specified 277 transmissions can notify providers whether each individual claim will or will not be processed. Typically, 277 transactions based on this TR3 are sent automatically from a payer's front-end editing environment. 005010X214 is available for purchase individually or in a package with 005010X231, Implementation Acknowledgment for Health Care Insurance (999), here:
http://store.x12.org Opens in New Window

005010X228

Health Care Claim Pending Status Information
The last of these three 277-based TR3s is 005010X228. Transactions based on this TR3 are used by payers to notify providers of the status of claims after the individual claims have successfully passed front-end edits and are in the adjudication process. Transactions based on 005010X228 are typically sent automatically; usually triggered by changes in status or elapsed time in adjudication. 005010X228 is available for purchase here:
www.wpc-edi.com/x228 Opens in New Window