EDI Transactions (ANSI X12)

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  • 270 ”” eligibility & benefit inquiry – Is the patient an insured of this payer?
  • 271 ”” eligibility & benefit response (response to 270) – A yes or no response that the patient is insured
  • 276 ”” claims status inquiry (follows 837 submission)
  • 277 ”” claim status response (response to 276)
  • 835 ”” claim payment/advice (follows 837)
  • 837  – medical claim is paid, and amount of payment and the patient’s financial responsibility
  • 837D ”” claim submission for dental claims
  • 837I ”” claim submission for institutional claims
  • 837P ”” claim submission for professional claims

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