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HEALTH CARE TR3 SPREADSHEETS

005010X279 - Health Care Eligibility/Benefit Inquiry and Info Response

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$550.00 / single user license

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The Health Care Eligibility/Benefit Inquiry and Information Response Implementation Guide (005010X279) describes the use of the Eligibility, Coverage or Benefit Inquiry (270) Version/Release 005010 transaction set and the Eligibility, Coverage, or Benefit Information (271) Version/Release 005010 transaction set for the following business usages:

  • Determine if an Information Source organization, such as an insurance company, has a particular subscriber or dependent on file
  • Determine the details of health care eligibility and/or benefit information

HEALTH CARE TR3 SPREADSHEETS

005010X212 - Health Care Claim Status Request and Response

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$550.00 / single user license

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The Health Care Claim Status Request and Response Implementation Guide (005010X212) describes the use of the ANSI ASC X12.316 Health Care Claim Status Request (276) transaction set and the ANSI ASC X12.317 Health Care Claim Status Notification (277) transaction set for the following business usage:

  • Request the status of health care claim(s) and respond with information regarding the specified claim(s).

HEALTH CARE TR3 SPREADSHEETS

005010X217 - Health Care Services Review - Request and Response

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$550.00 / single user license

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The Health Care Services Review Request and Response (005010X217) Implementation Guide describes the use of the ANSI ASC X12 Health Care Services Review Information (278) Version/Release 005010 transaction set for the following business usages:

  • Health care admission certificate requests and responses
  • Referral requests and responses
  • Health care services certification requests and responses
  • Extend certification requests and responses
  • Certification appeal requests and responses

HEALTH CARE TR3 SPREADSHEETS

005010X218 - Payroll Deducted & Other Premium Payment

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$550.00 / single user license

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The Payroll Deducted and Other Group Premium Payment for Insurance Products Implementation Guide (005010X218) describes the use of the ANSI ASC X12 Payment Order/Remittance Advice (820) transaction set, version 5010 for the following business usage:

  • Transmit payroll deducted premiums for a wide variety of insurance products, to include life, health, property and casualty, and disability.

This guide was also designed for health care premium payments between federal and state governments, government agencies, and private industry.

HEALTH CARE TR3 SPREADSHEETS

005010X220 - Benefit Enrollment and Maintenance

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$550.00 / single user license

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The Health Care Benefits Enrollment and Maintenance Implementation Guide (005010X220) describes the use of the ANSI ASC X12 Benefit Enrollment Maintenance (834) transaction set for the following business usage:

  • Transfer enrollment information from the sponsor of insurance coverage, benefits, or policy to a payer.

HEALTH CARE TR3 SPREADSHEETS

005010X221 - Health Care Claim Payment/Advice

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$550.00 / single user license

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The Health Care Claim Payment/Advice Implementation Guide (005010X221) describes the use of the ANSI ASC X12 Health Care Claim Payment/Advice (835) transaction set for the following business usages:

  • Make payment on a health care claim
  • Send an Explanation of Benefits (EOB) remittance advice
  • Make payment and send an EOB in the same transaction

HEALTH CARE TR3 SPREADSHEETS

005010X222 - Health Care Claim: Professional

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$550.00 / single user license

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The Health Care Claim: Professional Implementation Guide (005010X222) describes the use of the ANSI ASC X12 Health Care Claim (837) transaction set for the following business usage:

  • Submit and transfer professional claims and encounters from health care providers to health care payers and between payers

HEALTH CARE TR3 SPREADSHEETS

005010X223 - Health Care Claim: Institutional

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$550.00 / single user license

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The Health Care Claim: Institutional Implementation Guide (005010X223) describes the use of the ANSI ASC X12 Health Care Claim (837) transaction set for the following business usage:

  • Submit and transfer institutional claims and encounters from health care providers to health care payers and between payers

HEALTH CARE TR3 SPREADSHEETS

005010X224 - Health Care Claim: Dental

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$550.00 / single user license

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The Health Care Claim: Dental Implementation Guide (005010X224) describes the use of the ANSI ASC X12 Health Care Claim (837) transaction set for the following business usage:

  • Submit and transfer dental claims and encounters from health care providers to health care payers

HEALTH CARE TR3 SPREADSHEETS

005010X298 - Post Adjudicated Claims Data Reporting: Professional

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$550.00 / single user license

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The Post Adjudicated Claims Data Reporting: Professional Implementation Guide (005010X298) describes the use of the ASC X12 Health Care Claim (837) transaction set for reporting health care professional service post adjudicated data:

  • to satisfy state and federal reporting requirements such as; Medicare and Medicaid encounters, All Payer Claims Databases, and Health Care Insurance Exchanges
  • for use in health data analysis from payer data

HEALTH CARE TR3 SPREADSHEETS

005010X299 - Post Adjudicated Claims Data Reporting: Institutional

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$550.00 / single user license

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The Post Adjudicated Claims Data Reporting: Institutional Implementation Guide (005010X299) describes the use of the ASC X12 Health Care Claim (837) transaction set for reporting health care institutional service post adjudicated data:

  • to satisfy state and federal reporting requirements such as; Medicare and Medicaid encounters, All Payer Claims Databases, and Health Care Insurance Exchanges
  • for use in health data analysis from payer data

HEALTH CARE TR3 SPREADSHEETS

005010X300 - Post Adjudicated Claims Data Reporting: Dental

Format: CSV

$550.00 / single user license

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The Post Adjudicated Claims Data Reporting: Dental Implementation Guide (005010X300) describes the use of the ASC X12 Health Care Claim (837) transaction set for reporting health care dental service post adjudicated data:

  • to satisfy state and federal reporting requirements such as; Medicare and Medicaid encounters, All Payer Claims Databases, and Health Care Insurance Exchanges
  • for use in health data analysis from payer data

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About ASC X12 TR3 Spreadsheets

ASC X12 TR3 Spreadsheets are a representation of the ASC X12 TR3 PDFs delivered as a CSV file that can be opened with a spreadsheet. There is a row for each loop, segment, and data element. There is a column for the relevant attributes of each row.
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