Product: X12 EDI
Transaction: 269
Article Link: http://help.truecommerce.com/en/articles/10220838-x12-269-health-care-benefit-coordination-verification
269 - Health Care Benefit Coordination Verification
FUNCTIONAL GROUP=HV
This X12 Transaction Set contains the format and establishes the data contents of the Health Care Benefit Coordination Verification Transaction Set (269) for use within the context of an Electronic Data Interchange (EDI) environment. This transaction set can be used to transmit and respond to Health Care Benefit coordination information such as claim identification, previous adjudication details, and adjudication verification from one Health Care Payer to another. The transaction can be used as a notification of benefit coordination information. When used as a request for verification of benefit coordination information, the 269 is the response to that request for benefit coordination information verification.
SCHEMA
ST
Segment | Name | Position |
ST | 0100 | |
BGN | Beginning Segment | 0200 |
1000
Segment | Name | Position |
N1 | 0300 | |
N2 | 0400 | |
N3 | 0500 | |
N4 | 0600 | |
PER | 0700 |
2000
Segment | Name | Position |
TRN | Trace | 0100 |
CLP | Claim Level Data | 0200 |
DTP | Date or Time or Period | 0300 |
AAA | Request Validation | 0400 |
2100
Segment | Name | Position |
NM1 | Individual or Organizational Name | 0500 |
N2 | 0600 | |
N3 | 0700 | |
N4 | 0800 | |
REF | 0900 | |
PER | 1000 | |
DTP | Date or Time or Period | 1100 |
2200
Segment | Name | Position |
SVC | Service Information | 1200 |
DTP | Date or Time or Period | 1300 |
SE | Transaction Set Trailer | 1400 |
COMMENTS
Notes |
|
2/0100 | The TRN segment is used to uniquely identify and tie an inquiry to a response. |
rev 29/11/2024