BC Advantage - 2022 Issue 9

Administrative Simplification Transactions Basics

The Centers for Medicare & Medicaid Services (CMS) has created a series of fact sheets to help explain how HIPAA (Health Insurance Portability and Accountability Act) electronic adopted transactions streamline health care billing through the use of standards and operating rules.The fact sheets cover the following transactions:Claim status request/notification X12N 276/277 transactionEligibility, coverage, or benefit inquiry/information X12N 270/271 transactionElectronic funds transfer and remittance advice X12N 835 transactionCoordination of benefits X12N 837 transaction Visit the Transactions section of the Administrative Simplification website to learn more about the standards and operating rules for each transaction.Source: CMS ...

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