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Health Care Services - Review Inquiry and Response 005010 X215

Health Care Services -- Review Inquiry and Response implementation guide describes the use of the X12 Health Care Services Review Information (278) transaction set for assisting providers who inquire about certification decisions and the Utilization Management Organizations (UMO) who respond to those inquiries.

Intended trading partners include: health care providers, such as hospitals, physicians, medical groups, independent physician associations, and facilities; health care review entities, such as insurance companies, HMOs, PPOs, health care purchasers, professional review organizations, and other utilization review organizations.


  • Type:

    TR3

  • Industries:

    Health Care & Insurance

  • Intended Trading Partners:

    Intended trading partners include: health care providers, such as hospitals, physicians, medical groups, independent physician associations, and facilities; health care review entities, such as insurance companies, HMOs, PPOs, health care purchasers, professional review organizations, and other utilization review organizations.

  • Set ID:

    278

  • Version:

    005010

  • Maintained By:

    X12N

  • Publication Date:

    05/01/2006

  • Publication ID:

    X215

  • Resources:

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