Informational Forum for 278s and 275 TR3s
X12 will conduct an informational forum related to the above implementation guides on Wednesday, April 1, 2020 at 3:00 PM Eastern Time.
The Health Care Services Review Inquiry and Response Implementation Guide (007030X327) describes the use of the X12 Health Care Services Review Information (278) transaction set for the following business usages:
- Make inquiries to utilization management organizations for information on previously processed health care services
- Send response(s) to inquiry(ies) on previously processed health care services
The Health Care Services Review – Notification Implementation Guide (007030X328) describes the use of the X12 Health Care Services Review Information (278) transaction set for the following business usage: Notification of interested parties concerning events related to a health care services review such as:
- Patient arrival notice
- Patient discharge notice
- Patient transfer notice
- Notification of certification to primary care physician (PCP), utilization management organization (UMO), or other service providers
- Certification notice change
The Health Care Services Review Request and Response Implementation Guide (007030X342) describes the use of the X12 Health Care Services Review Information (278) transaction set for the following business usages:
- Health care admission certificate requests and responses
- Referral requests and responses
- Health care services certification requests and responses
- Extend certification requests and responses
- Certification appeal requests and responses
The Additional Information to Support a Health Care Services Review Implementation Guide (007030X343) describes the use of the ASC X12 Patient Information (275) transaction set for the following business usage:
- To assist those who send additional supporting information or who receive additional supporting information to a health care claim services review.
These implementation guides were developed by X12’s Insurance Subcommittee and were recently the subject of public review. The public review comments and associated work group responses will be reviewed at the informational forum. This is the final opportunity for public discussion of the comments and any resulting revisions.
The draft revisions, submitted comments, and associated responses are available athttp://forums.x12.org until the conclusion of the informational forum. These drafts are provided for public review and cannot be used for any other purpose without permission from X12. Responses to all comments will be posted no later than fifteen (15) days prior to the informational forum.
To participate, register for this informational forum here by March 31, 2020. After registering, you will receive a confirmation email containing information about joining the webinar.
Questions may be directed to info@x12.org.
About X12
X12, chartered by the American National Standards Institute for more than 40 years, develops and maintains EDI standards and XML schemas which drive business processes globally.