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Health Care Services Review Notification and Acknowledgment 005010 X216

The Health Care Services Review Notification and Acknowledgment implementation guide describe the use of the X12 Health Care Services Review Information (278) transaction set for the following business usages: advance notification of authorizations for planned or scheduled admissions, health services, specialty referrals; completion notification of admissions and discharges that have occurred or the completion of the delivery of previously authorized health care services; information copy or courtesy copy to notify a receiving entity of a health care services review outcome; acknowledgment of receipt of a health care services review notification or information copy.

Intended trading partners include: providers, such as physicians, medical groups, independent physician associations (IPAs), and preferred provider organizations (PPOs); facilities, such as hospitals, clinics, and school and employer clinics; health care review entities, such as insurance companies, health maintenance organizations (HMOs), professional review organizations (PROs), and UMOs.


  • Type:

    TR3

  • Industries:

    Health Care & Insurance

  • Intended Trading Partners:

    Intended trading partners include: providers, such as physicians, medical groups, independent physician associations (IPAs), and preferred provider organizations (PPOs); facilities, such as hospitals, clinics, and school and employer clinics; health care review entities, such as insurance companies, health maintenance organizations (HMOs), professional review organizations (PROs), and UMOs.

  • Set ID:

    278

  • Version:

    005010

  • Maintained By:

    X12N

  • Publication Date:

    05/01/2006

  • Publication ID:

    X216

  • Resources:

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