X12 HIPAA 820 Payment Order
The EDI 820 transaction set provides the EDI format for transmitting information relating to payments. It is typically used in conjunction with an electronic transfer of funds for payment of goods, insurance premiums, or other transactions. The actual fund's transfer is often coordinated through the Automated Clearinghouse (ACH) system, and an 820 may be effectively wrapped in an ACH banking transaction. The 820 transaction is used in a number of situations:
- By businesses to provide instructions to banks for making a payment, such as a funds transfer, to a payee
- By businesses directly to individual suppliers to communicate the details of pending payment, including adjustments reflected in the payment
- By companies providing premium payment information to health insurance plans
The information provided in an 820 document includes payer and payee identification, bank and account IDs, invoice number(s), adjustments from an invoice, billed, and paid amounts. This information allows the suppliers and health plans to reconcile payments they receive against invoices they have issued. In healthcare, the 820 is similar to the EDI 835 transaction set. The 820 is specifically for plan sponsors – that is, companies providing healthcare benefits to their employees – to transmit information on premium payments to the health plans.
X12 HIPAA 820 Specification
X12 HIPAA 820 specification is available at:
X12 HIPAA 820 Code Example
X12 HIPAA 820 code example is available at:
X12 HIPAA 820 Sample File
ISA*00* *00* *ZZ*1234567 *ZZ*11111 *170508*1141*^*00501*000000101*1*P*:~ GS*HC*XXXXXXX*XXXXX*20170617*1741*101*X*005010X218~ ST*820*0001*005010X218~ BPR*C*19000*C*ACH*CTX*01*999999992*DA*12345678*1030449999**01*199999999*DA*98765*20070516~ TRN*1*12345*1030449999~ REF*14*12345~ N1*PE*DEF HEALTH CARE INC.*FI*012222222~ N1*PR*ABC PLASTICS*FI*123456789~ ENT*1*2L*FI*123456789~ RMR*IK*970501001*PI*16500~ IT1*1~ SLN*1**O*5*IE~ SLN*2**O*75*10~ RMR*IK*970501002*PI*250~ IT1*1~ SLN*1**O*25*IE~ SE*15*0001~ GE*1*101~ IEA*1*000000101~
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