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X12 HIPAA 4010 and X12 HIPAA 5010

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X12 HIPAA versions 4010, 5010, and 5010 Errata

HIPAA 5010 expands HIPAA regulation to include electronic transmission of healthcare transactions, including eligibility, claim status, referrals, claims, and remittances. ASC X12 Version 5010 is the adopted standard format for transactions, except those with retail pharmacies.

HIPAA standard is used by physicians, clearinghouses, hospitals, pharmacies, payers, and dentists. Some of the most popular messages are 837P, 270, 271, 278, 276, 834, etc.

 

EDI Tools for .NET supports all transactions for the X12 HIPAA standard, in versions 4010, 5010, and 5010 Errata.

A collection of ready-to-use X12 HIPAA templates is offered as part of the product, however, if a transaction is missing, or needs to be modified, please contact us.

All HIPAA templates are also available in interactive view in EDI Webpad.

Additional X12 HIPAA resources:

The table below shows the X12 HIPAA templates for versions 4010, 5010, and 5010 Errata which are available in EDI Tools for .NET. The "Message" column shows the transaction ID. The "4010", "5010", and "5010 Errata" columns list all available X12 templates in EDI Tools for .NET, and link to the interactive view of the template in EDI Webpad.

 

X12 HIPAA 270, 271, 276, 277, 278, 820, 834, 835, 837P, 837I, 837D

Message Description 4010 5010 5010 Errata
X12 270 Eligibility, Coverage or Benefit Inquiry 4010X092A1 5010X279 5010X279A1
X12 271 Eligibility, Coverage or Benefit Information 4010X092A1 5010X279 5010X279A1
X12 276 Health Care Claim Status Request 4010X093A1 5010X212  
X12 277 Health Care Information Status Notification 4010X093A1 5010X212  
X12 277 CA Health Care Claim Acknowledgment     5010X214
X12 278 Health Care Services Review Information Request 4010X094A1 5010X217  
X12 820 Payment Order/Remittance Advice 4010X061A1 5010X218 5010X306
X12 834 Benefit Enrollment and Maintenance 4010X095A1 5010X220 5010X220A1
X12 835 Health Care Claim Payment/Advice 4010X091A1 5010X221 5010X221A1
X12 837P Health Care Claim Professional 4010X098A1 5010X222 5010X222A1
X12 837I Health Care Claim Institutional 4010X096A1 5010X223A1 5010X223A2
X12 837D Health Care Claim Dental 4010X097A1 5010X224A1 5010X224A2
X12 999 Implementation Acknowledgment     5010X231A1

 

X12 HIPAA parsing and generation examples

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