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Health Care Eligibility Benefit Inquiry and Response

The Health Care Eligibility Benefit Inquiry and Response implementation guide describes the use of the Eligibility, Coverage or Benefit Inquiry (270) transaction set and the Eligibility, Coverage, or Benefit Information (271) set for determining if an information source organization, such as an insurance company, has a particular subscriber or dependent on file and for determining the details of health care eligibility and/or benefit information.

Intended trading partners include: health care providers, such as hospitals and physicians; health care payers, such as insurance companies, HMOs, and PPOs; state and federal programs, such as Medicare, Medicaid, and TRICARE (CHAMPUS).


  • Type:

    TR3

  • Industries:

    Health Care & Insurance

  • Intended Trading Partners:

    Intended trading partners include: health care providers, such as hospitals and physicians; health care payers, such as insurance companies, HMOs, and PPOs; state and federal programs, such as Medicare, Medicaid, and TRICARE (CHAMPUS).

  • Set ID:

    270/271

  • Version:

    003070

  • Maintained By:

    X12N

  • Publication Date:

    06/01/1997

  • Publication ID:

    X023

  • Resources:

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