Financial

Exchange information about money that's due and money that's paid.

Registration and Eligibility

These interfaces are used in registration and eligibility processes.

Outgoing Admission Notification (X12 278) read the specOutgoing Admission Notification (X12 278) technical specification

Used to notify a payer or health plan about an admission for one of their covered a patients. The ANSI X12 278 transaction is used for both the original notification of the admission and the payer response that might follow. Such a response might contain the reference/authorization number to be sent later on the claim.
Current integrations include
  • Aetna
  • Availity
  • Change Healthcare
  • Cigna
  • Clinical Computer Systems, Inc.
  • Experian Health
  • FinThrive
  • Healthcare IP
  • Horizon
  • Humana
  • Humata Health
  • Johns Hopkins HealthCare LLC
  • NAS United Healthcare Services
  • Ohio - Public Health Agencies
  • Optum
  • Post-n-track
  • Quartz
  • Recondo
  • Relay Health
  • The Advisory Board
  • TriZetto Provider Solutions, a Cognizant Company
  • United Healthcare
  • Waystar

Batch Eligibility Query (BEQ) read the specBatch Eligibility Query (BEQ) technical specification

Outbound BEQ request and Incoming BEQ response. BEQ is a way for plans to submit batches of individuals for verification of various eligibilities.