Basic EDI Flowchart with EDI Data Examples Including Encounter How To

This video is a nice overview with #Flowchart, #EDI #data and even #Encounters Explanation at the end. The best place to go for an explanation of HIPAA EDI #transactions.
Really nice Encounter overview! Most folks don't know how to cut up an 837 Encounter.
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[@solanki0412]

Very nicely done. Thanks!!
Regarding EDI 278, what is the general differentiator between those 278 since the same number is used
Also 270 and 271 are used before sending an EDI 834 just like in the case of EDI 837
And I have read about EOP and EOB returned along with EDI 835 but not able to understand what those are actually and how is it sent, like an EDI document or they are included withtin the EDI 835

[@remorabay]

278 Request has BHT-02="13" and the 278 Response has BHT-02="11". That is the difference; also, the 278 Response has an HCR segment that lists the approval/no-approval. No, the 270/271 eligibility must occur after an enrollment (834) transaction.

[@remorabay]

The member has to enroll first (834); after that, the provider may send an eligibility request (270) to check for dates and types of coverage for the patient/member. When the payer receives the 270, they can respond with an eligibility response (271).

[@sushantsurankar4831]

@Remora Bay are there any standard companion guides that I can refer ? especially for 834, 837 (Inst , Prof and dental) and 835 files.

[@remorabay]

WPC sells subscriptions; however, MANY (MANY) people do not know how to build a real Companion Guide...what they end up making is closer to an Implementation Guide, with all of the Loops, Segments, Elements and Composites, filled in......the presents a FREE opportunity. In other words, just do a search for "837 Companion Guide" or "834 Companion Guide", etc. and you can find all kinds of FREE guides that will get you close. If you are working for a Payer or Tech Company, simply ask them to purchase the specific HIPAA EDI Implementation Guide....for the 837 or 834, etc.