Monday 05/13/2024 06:40 AM CST
Trading Partner Enrollment: Summary
Profile Information
Trading Partner Name
_
Address
_
_
City
_
State
_
Zip Code
_
Type of Business
_
Enrollment Contact Information
Contact Name
_
Contact Phone
_
Ext
_
Contact Fax Number
_
Contact Email
_
Preferred Communication Method
_
EDI Information
EDI Contact Name
_
EDI Contact Phone
_
Ext
_
EDI Contact Email
_
Transaction Sets
_
5010 - 270 - Batch - X12 - Health Care Eligibility Benefit Inquiry
5010 - 271 - Batch - X12 - Health Care Eligibility Benefit Response
5010 - 276 - Batch - X12 - Health Care Claim Status Request
5010 - 277 - Batch - X12 - Health Care Claim Status Response
5010 - 278 - Batch - X12 - Health Care Services Request/Response
5010 - 278 - Batch - X12 - Health Care Services Request/Response
5010 - 820 - Batch - X12 - Payroll Deducted and Other Group Premium Payment for Insurance Products
5010 - 820 - Batch - HIX - Private Option Premium Payment for Insurance Products
5010 - 834 - Batch - X12 - Benefit Enrollment and Maintenance
5010 - 835 - Batch - X12 - Health Care Claim Payment/Advice
5010 - 837P - Batch - X12 - Health Care Claim: Professional
5010 - 837I - Batch - X12 - Health Care Claim: Institutional
5010 - 837D - Batch - X12 - Health Care Claim: Dental
5010 - 999 - Batch - X12 - Functional Acknowledgment
5010 - TA1 - Batch - X12 - Interchange Acknowledgment
No Covered Providers exist for this enrollment.
Privacy Notice