What is EDI 278-A1 Health Care Services Review — Request for Review?
One of the EDI X12 transactions, EDI 278 is sent by healthcare organizations for requesting a review. The EDI 278 transaction set is used to submit information in the following categories:
- Completion notification – for patient arrival or discharge from a facility
- Advance notification – for scheduled inpatient or specialty care
- Change notification – for reporting amendments to previously sent information
- Information copy – for health services review details sent to service providers
EDI X12 278-A1 Health Care Services Review — Request for Review Sample
The following EDI 278-A1 sample file demonstrates the different data elements and segments that are found within an EDI 278-A1 transaction document.
ISA*00* *00* *ZZ*9012345720010 *ZZ*9088877320010 *151010*0817*+*00501*000001523*0*T*~ GS*HI*9012345720010*9088877320010*20151010*0817*1523*X*005010X217~ ST*278*1523*005010X217~
NM1*X3*2*NOVITAS SOLUTIONS INC*****PI*2.16.840.1.113822.214.171.124.1.110.11~[NM109 => RC OID] HL*2*1*21*1~
N3*2545 LORD BALTIMORE DR~
N3*7111 SECURITY BLVD~
N3*7602 WINDSOR WAY~
N3*AMBSTREET RENDERING PROVIDER 2010EA ~
Workflow for the Exchange of EDI 278-A1 Health Care Services Review — Request for Review
One of the X12 transactions, EDI 278-A1 is used either as a one-way transaction for referring to an individual patient event or a two-way inquiry/response transaction. Healthcare service providers generally send an EDI 278-A1 transaction set for requesting a review or reporting the results of a healthcare services review.
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