EDI Transaction Set

EDI 269: Health Care Benefit Coordination Verification

EDI 269 is the X12 Health Care Benefit Coordination Verification transaction set, used within Electronic Data Interchange (EDI). This transaction set can be used to transmit and respond to Health Care Benefit coordination information such as claim identification, previous adjudication details, and adjudication verification from one Health Care Payer to another. The transaction can be used as a notification of benefit coordination information.

What the 269 transaction set covers

Health Care Benefit Coordination Verification This X12 Transaction Set contains the format and establishes the data contents of the Health Care Benefit Coordination Verification Transaction Set (269) for use within the context of an Electronic Data Interchange (EDI) environment. This transaction set can be used to transmit and respond to Health Care Benefit coordination information such as claim identification, previous adjudication details, and adjudication verification from one Health Care Payer to another. The transaction can be used as a notification of benefit coordination information. When used as a request for verification of benefit coordination information, the 269 is the response to that request for benefit coordination information verification.

How Interlink handles the 269

Interlink Commerce maps, transmits, and monitors the 269 for you as part of fully managed EDI — connected straight to your ERP or systems, certified against your retailer’s requirements, and billed only when you trade. Most suppliers go live within 30 days.

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