EDI Transactions (ANSI X12)

• 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