Support for HIPAA EDI Transactions

May 9, 2023

We now support all HIPAA EDI transactions in our X12 EDI parser and in our public EDI Viewer.

HIPAA transactions cover healthcare claim submissions, payments, eligibility checks, and enrollment. The master list of HIPAA transactions is published by CMS.

837 (claim submission) and 835 (claim payment/advice) transactions constitute the core of HIPAA/healthcare transactions. We’ve always had solid support for these two transaction types in our EDI Viewer and in our other products.

We’ve added support for the rest of the HIPAA transactions, namely:

Health Care Eligibility/Benefit Inquiry (270)
Benefit Enrollment and Maintenance Set (834)
Health Care Eligibility/Benefit Response (271)
Health Care Claim Status Request (276)
Health Care Claim Status Notification (277)
Health Care Service Review Information (278)

We now also support “general” transactions from the “Communications & Controls” space that are used across the board for EDI exchanges:

Functional Acknowledgment (997)
Implementation Acknowledgment (999)

We’ve also added support for transactions outside the healthcare domain based on the feedback from our users:

Motor Carrier Load Tender (204)
Motor Carrier Freight Details and Invoice (210)
Payment Order/Remittance Advice (820)
Purchase Order (850)
Planning Schedule with Release Capability (830)
110, 309, 810, 856 transactions

If you’re interested in specific transactions that are not yet supported, go to the EDI Viewer, click on “Support,” and submit your request.