Section title: X12 EDI Examples
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ASC X12 Version: 008030 | Transaction Set: 278 | TR3 ID: 008030X328

Example 04 - Acknowledgment of Receipt (BHT02 = 53)

The notification receiver can return a 278 acknowledgment to indicate the successful receipt of the notification. The acknowledgment sender can assign a receipt number to the acknowledgment at the Patient level and/or at each Service level associated with the notification. The following example demonstrates an acknowledgment of receipt of a notice of admission.

Transmission Explanation

HL*4*3*EV*0~
TRN*2*20110820*123456789~
UM*AR*I*2~
REF*NT*IP2003073101~
DTP*435*D8*20110821~

The acknowledgment echoes back the notification sender trace number and other identifying information associated with the service notification. In addition, the acknowledgment sender has assigned an administrative reference number (REF01 = NT) to acknowledge receipt of the notice of admission.