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    EDI 278-A1 Health Care Services Review — Request for Review

    November 20th, 2019

    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~
    BHT*0007*13*4000000000001*20151010*0817~
    HL*1**20*1~
    NM1*X3*2*NOVITAS SOLUTIONS INC*****PI*2.16.840.1.113883.13.34.110.1.110.11~[NM109 => RC OID] HL*2*1*21*1~
    NM1*1P*1*DOE*JOHN****XX*1234567893~
    N3*2545 LORD BALTIMORE DR~
    N4*WINDSORMILL*MD*21244~
    PER*IC*JAMES WILBER*FX*4105850054*TE*4105850064*EX*7854~
    HL*3*2*22*1~
    NM1*IL*1*CLINGTON*TONY****MI*212123289A~
    N3*7111 SECURITY BLVD~
    N4*BALTIMORE*MD*21244~
    DMG*D8*19611111*M~
    HL*4*3*EV*1~
    TRN*1*201503251246005544*HIH1238946~
    UM*HS*I*56*41:B~
    DTP*AAH*RD8*20151020-20151219~
    HI*BK:78609~
    PWK*M1*EL***AC*ACN1~
    NM1*DK*1*HANDLE*PETER**M.D.**XX*1345678902~
    N3*7602 WINDSOR WAY~
    N4*WINDSORMILL*MD*21244~
    NM1*SJ*1*EATHAN*DUBIN*T***XX*1456789019~
    N3*AMBSTREET RENDERING PROVIDER 2010EA ~
    N4*WINDSORMILL*MD*21244~
    HL*5*4*SS*0~
    TRN*1*0070-20150320175012376*9555555555~
    SV1*HC:A0428:QM**UN*30~
    SE*30*1523~
    GE*1*1523~
    IEA*1*000001523~

    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.

    Stay EDICompliant with Astera EDIConnect

    Astera EDIConnect is an enterprise-grade EDI solution that simplifies the process of sending and receiving EDI messages. Featuring an intuitive EDI transaction parser, validator, and builder, Astera EDIConnect delivers the performance and scalability to efficiently process EDI files of any complexity and size.

    Find out more about the industries we’ve helped and how we did it.

    Authors:

    • Iqbal Ahmed
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