By | 2019-10-10T05:33:09+00:00 October 10th, 2019|

What is EDI 834-A1 Benefit Enrollment and Maintenance?

The EDI 834 -A1 transaction set is used for conveying member enrollment details, such as plan subscription and employee demographic information. This transaction set is also used for new enrollments, changes in the member’s existing enrollment information, and disenrollment of members.

EDI X12 834-A1 Benefit Enrollment and Maintenance Sample

The following example details the format of an EDI 834 document[1].

ST*834*0001*005010X220A1~
BGN*00*XXX20110524C002*20110524*2215****2~
REF*38*G02408~
DTP*007*D8*20110524~
N1*P5*SUMMACARE ENROLL*FI*99-9999999~
N1*IN*SUMMACARE*FI*999999999~
INS*Y*18*021*28*A***FT~
REF*0F*111224444~
REF*1L*G04559SB~
DTP*336*D8*20110501~
NM1*IL*1*DOE*JOHN*I~
PER*IP**HP*3305551111~
N3*486 SOME STREET~
N4*AKRON*OH*44313~
DMG*D8*19640101*M~
HD*021**HLT~
DTP*348*D8*20110601~
LX*1~
NM1*P3*1******SV*170*25~
SE*20*0001~

Workflow for the Exchange of EDI 834-A1 Benefit Enrollment and Maintenance

Upon receiving an EDI 834-A1 document, the recipient sends an EDI 999 Implementation Acknowledgement to confirm that the file was received and provide feedback on the acceptance of the document.

Stay EDI Compliant with Astera EDIConnect

Designed to facilitate electronic data interchange, Astera EDIConnect is an intuitive, code-free solution that supports EDIFACT, HL7, and ANSI X12 EDI formats. With a built-in EDI parser, validator, and transaction builder, Astera EDIConnect makes the process of sending and receiving EDI documents simple and easy.

[1] https://www.summacare.com/-/media/project/summacare/website/document-library/edi-and-hippa/hippa-summacare-834-5010-companion-guide.pdf?la=en

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