| Transaction |
Standard |
| Eligibility for a health plan (request and response)—Dental, professional, and institutional |
X12N 270/271 |
| Eligibility for a health plan (request and response)—Retail pharmacy drugs |
NCPDP D.0 |
| Enrollment and disenrollment in a health plan |
X12N 834 |
| Referral certification and authorization (request and response)—Dental, professional, and institutional |
X12N 278 |
| Referral certification and authorization (request and response)—Retail pharmacy drugs |
NCPDP D.0 |
| Health care claims or equivalent encounter information—Dental |
X12N 837D |
| Health care claims or equivalent encounter information—Professional |
X12N 837P |
| Health care claims or equivalent encounter information—Institutional |
X12N 837I |
| Health care claims or equivalent encounter information—Retail pharmacy |
NCPDP D.0 |
| Health care claims or equivalent encounter information—Retail pharmacy supplies and professional services |
X12N 837P and NCPDP D.0 |
| Health care claim status (request and response) |
X12N 276/277 |
| Coordination of Benefits - Retail pharmacy drugs |
NCPDP D.0 |
| Coordination of Benefits - Dental |
X12N 837D |
| Coordination of Benefits - Professional |
X12N 837P |
| Coordination of Benefits - Institutional |
X12N 837I |
| Health care payment and remittance advice |
X12N 835 |
| Health care electronic funds transfers (EFT) and health care payment and remittance advice (RA) |
NACHA CCD+ and X12N 835 TRN Segment |
Note: Transactions in this table are listed in their business process sequence.
You also may be interested in...
FAQs
4/19/2023
View questions and answers about the nationwide standards for HIPAA compliant electronic administrative health care transactions.
Page 1 of 1
, showing items 1 - 1
You are leaving Health.mil
The appearance of hyperlinks does not constitute endorsement by the Department of Defense of non-U.S. Government sites or the information, products, or services contained therein. Although the Defense Health Agency may or may not use these sites as additional distribution channels for Department of Defense information, it does not exercise editorial control over all of the information that you may find at these locations. Such links are provided consistent with the stated purpose of this website.
You are leaving Health.mil
View the external links disclaimer.
Last Updated: March 07, 2017