Submitter documents
Electronic Claims Attachments
This document has been written to assist those who will be submitting claims attachments
associated with the ASC X12 837D, 837I and 837P Health Care Claim transactions. These
procedures are based on best practice documents that were developed by the Administrative
Uniformity Committee (AUC) to complement the Minnesota state law requiring the electronic
exchange of administrative health care transactions, effective July 15, 2009. The complete
AUC best practice procedures can be referenced through a website link in this document.
Companion Documents
Use the ClearConnect companion documents listed below to create a HIPAA-compliant
transaction. In addition, download each payer's companion document from
the payer's website and visit the Washington
Publishing Company web site to download and/or print these required
documents:
- Appropriate HIPAA implementation guide
- HIPAA implementation guide addenda
Professional Claims
This document is intended to be used with the ASC X12 837P Health Care
Claim Implementation Guide and the Addenda as mandated under the Health
Insurance Portability and Accountability Act (HIPAA). This document
should also be used with each payer’s
companion document. The combination of these documents provides every
trading
partner with
the information needed to do business with ClearConnect.
- Professional Claims CD/837P (004010X098A1)
Institutional Claims
This document is intended to be used with the ASC X12 837I Health Care
Claim Implementation Guide and the Addenda as mandated under the Health
Insurance Portability and Accountability Act (HIPAA). This document should
also be used with each payer’s companion document. The combination
of these documents provides every trading partner with the information
needed to do business with ClearConnect and to meet each payer’s
adjudication requirements.
- Institutional Claims CD/837I (004010X096A1)
Claim Payment/Advice
This companion document has been written to assist those who will be
implementing the ASC X12N 835 Health Care Claim Payment/Advice transaction.
The specific data that will be provided is noted in the comment section
of the companion document. Refer to both the ASC X12N
835 (004010X091) Implementation Guide (IG) dated May 2000 and the
final approved Addenda to the IG for data
requirements.
Eligibility Benefit Inquiry and Response
This document has been written to assist those who will be implementing
the ASC X12N 270/271 Health Care Eligibility Benefit Inquiry and Response
transactions. The data recommendations and the specific data that will
be provided are noted in the comments section of the companion document.
Refer to both the ASC X12N 270/271 (004010X092) Implementation
Guide (IG) dated May 2000 and the final approved Addenda
to the IG for data requirements.
Health Care Claim Status Request and Response – Transaction not currently available
This companion document has been written to assist those who
will be implementing the ASC X12N 276/277 Health Care Claim Status Request
and
Response transactions. The data recommendations and the specific data
that will be provided are noted in the comments section of the companion
document. Refer to both the ASC X12N 276/277 (004010X093) Implementation
Guide (IG) dated May 2000 and the final approved Addenda to the IG for
data requirements.
- Health Care Claim Status Request and Response CD/ 276/277 (004010X093A1)
The Health Care Services Review – Request
for Review and Response Review – Transaction not currently available
This document has been written to assist those who will be implementing
the ASC X12N 278 Health Care Services Review - Request for Review and
Response transactions. The data recommendations and the specific data
that will be provided are noted in the comments section of the companion
document. Refer to both the ASC X12N 278 (004010X094)
Implementation Guide (IG) dated May 2000 and the final approved Addenda
to the IG for data requirements.