EDI Transaction Set
EDI 278: Health Care Services Review Information
EDI 278 is the X12 Health Care Services Review Information transaction set, used within Electronic Data Interchange (EDI). This transaction set can be used to transmit health care service information, such as subscriber, patient, demographic, diagnosis or treatment data for the purpose of request for review, certification, notification or reporting the outcome of a health care services review. Expected users of this transaction set are payors, plan sponsors, providers, utilization management and other entities involved in health care services review.
What the 278 transaction set covers
Health Care Services Review Information This X12 Transaction Set contains the format and establishes the data contents of the Health Care Services Review Information Transaction Set (278) for use within the context of an Electronic Data Interchange (EDI) environment. This transaction set can be used to transmit health care service information, such as subscriber, patient, demographic, diagnosis or treatment data for the purpose of request for review, certification, notification or reporting the outcome of a health care services review. Expected users of this transaction set are payors, plan sponsors, providers, utilization management and other entities involved in health care services review.
How Interlink handles the 278
Interlink Commerce maps, transmits, and monitors the 278 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.