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Health Care Services Review - Inquiry and Response 007030 X327

The Health Care Services Review Inquiry and Response implementation guide describes the use of the X12 Health Care Services Review Information (278) transaction set to make inquiries to utilization management organizations for information on previously processed health care services and to send response(s) to inquiry(ies) on previously processed health care services.

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:

    007030

  • Maintained By:

    X12N

  • Publication Date:

    10/01/2020

  • Publication ID:

    X327

  • Resources:

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