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Health Care Services Review - Request for Review and Response 007030 X342

The Health Care Services Review - Request for Review and Response implementation guide describes the use of the X12 Health Care Services Review Information (278) transaction set for health care admission certificate requests and responses referral requests and responses health care services certification requests and responses extend certification requests and responses and certification appeal requests and responses.

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:

    07/01/2020

  • Publication ID:

    X342

  • Resources:

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