EDI Transaction Set
EDI 271: Eligibility, Coverage Or Benefit Information
EDI 271 is the X12 Eligibility, Coverage Or Benefit Information transaction set, used within Electronic Data Interchange (EDI). This transaction set can be used to communicate information about or changes to eligibility, coverage or benefits from information sources (such as - insurers, sponsors, payors) to information receivers (such as - physicians, hospitals, repair facilities, third party administrators, governmental agencies). This information includes but is not limited to: benefit status, explanation of benefits, coverages, dependent coverage level, effective dates, amounts for co-insurance, co-pays, deductibles, exclusions and limitations.
What the 271 transaction set covers
Eligibility, Coverage or Benefit Information This X12 Transaction Set contains the format and establishes the data contents of the Eligibility, Coverage or Benefit Information Transaction Set (271) for use within the context of an Electronic Data Interchange (EDI) environment. This transaction set can be used to communicate information about or changes to eligibility, coverage or benefits from information sources (such as - insurers, sponsors, payors) to information receivers (such as - physicians, hospitals, repair facilities, third party administrators, governmental agencies). This information includes but is not limited to: benefit status, explanation of benefits, coverages, dependent coverage level, effective dates, amounts for co-insurance, co-pays, deductibles, exclusions and limitations.
How Interlink handles the 271
Interlink Commerce maps, transmits, and monitors the 271 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.