By Interface Type

ASC X12

ASC X12 standards are used for facilitating electronic interchange relating to business processes, in both healthcare and other industries. You can learn more from ASC X12.

Incoming Healthcare Claim Repricing Request (X12 837) read the spec

Tapestry receives incoming claim repricing requests through ANSI ASC X12 837 transactions.

Incoming External Paid Medical Claims (X12 837)

Loads external paid medical claims messages into Epic Payer Platform, using flat files in the 837 format.

Current integrations include

Humana

Incoming Pharmacy Price Sales Catalog to Willow Inventory Interface read the spec

Updates purchase contract records with up-to-date pricing and supplier item ID information.

Current integrations include

AmerisourceBergen
Anda
Auburn Pharmaceutical
BD
Cardinal Health WaveMark
McKesson
Morris & Dickson
Swisslog
TopRx

Outgoing Additional Information to Support a Health Care Services Authorization Query read the spec

Used in conjunction with an Outgoing Referral Request for Review - 278R, provides supporting clinical documentation for the request. Follows ANSI X12 specification 005010X211, ANSI X12 275 for Authorization, Additional Information to Support a Health Care Services Review (275)

Current integrations include

Anthem
Humana
Rhyme
Samaritan Health Plans
United Healthcare
Voluware

Incoming Claim File Acknowledgment Interface – 999 read the spec

This incoming interface loads claim file acknowledgment responses using industry standard ANSI ASC X12N 999 transactions.

Current integrations include

Blue Cross and Blue Shield of North Carolina
FinThrive
Optum

Outgoing Authorization Request as Notification (X12 278R) read the spec

Sends authorization decisions for covered patient referrals to third-party AP claims systems using the 278R format rather than 278N. Required by Texas Medicaid.

Current integrations include

Texas - Public Health Agencies

Tapestry Incoming Marketplace Benefit Enrollment and Maintenance

Receives eligibility information to create, term, and update Marketplace coverage information.

Tapestry Incoming Marketplace Premium Payment Information

Receives and processes premium payments associated with Marketplace coverages in Epic

Tapestry Outgoing Marketplace Benefit Enrollment and Maintenance

Sends marketplace coverage enrollment information government agencies or other entities.

Tapestry Incoming Referral Transfer Attachment (X12 275)

Receives electronic attachments and links them to Tapestry claims.

Incoming Additional Information to Support a Health Care Services Review - 275

Used in conjunction with an Incoming Referral Request for Review - 278R, provides supporting documents for the referral request. Follows ANSI X12 Specification 005010X211, ANSI X12 275 for Authorization, Additional Information to Support a Health Care Services Review.

Current integrations include

Johns Hopkins HealthCare LLC

Outgoing Additional Information for Health Care Claim (X12 275)

Sends additional information to support a Healthcare Claim from Epic's billing module, Resolute

Current integrations include

Blue Cross Blue Shield of Massachusetts
Cirius
FinThrive
Healthcare IP
Optum
Waystar

Outgoing Pharmacy Purchase Order from Willow Inventory read the spec

Sends medication purchase order requests to a supplier. The interface uses the ANSI X12 850 transaction set or GS1 for the request.

Current integrations include

Alliance Healthcare
AmerisourceBergen
Anda
Auburn Pharmaceutical
AutoMed
Baxter
BD
Cardinal Health WaveMark
CenterX
CuraScript
E.Novation
FFF Enterprises
Global Healthcare Exchange
Infor Global Solutions
McKesson
Mediq
Morris & Dickson
Oracle
Parata
Parmed
River City Pharma
SAP
TopRx

Incoming Pharmacy Purchase Order Invoice to Willow Inventory read the spec

Receives invoices from a supplier for purchase orders placed in Willow Inventory, Epic's medication inventory management system. The interface uses the ANSI X12 810 transaction set for the response.

Current integrations include

Alliance Healthcare
AmerisourceBergen
Anda
Auburn Pharmaceutical
AutoMed
Baxter
BD
Cardinal Health WaveMark
CenterX
FFF Enterprises
Global Healthcare Exchange
Macro Helix
McKesson
Morris & Dickson
Oracle
Parmed
SAP
Surescripts
TopRx

Outgoing Healthcare Claim: Professional (X12 837 Batch) read the spec

Sends professional claim information to payers. The 837 transmits claim information either for the purpose of payment, such as a provider sending a bill to a payer, or for the purpose of reporting, such as a delegated risk payer sending payment information to a health plan or the government.

Current integrations include

Change Healthcare
Gateway
McKesson
Santa Clara County (CA) - Public Health Agencies
Texas Medicaid & Healthcare Partnership

Incoming Healthcare Claim: Professional (X12 837) read the spec

Tapestry receives incoming professional, institutional, or dental claims through ANSI ASC X12 837 transactions. Standard version is batch with a real time option in upcoming version.

Current integrations include

Availity
Change Healthcare
DSG (Data Systems Group)
Humata Health
McKesson
Relay Health
Smart Data Solutions
Waystar

Outgoing Healthcare Claim Payment/Advice (X12 835) read the spec

Sends claim payment and remittance information to health care providers. The 835 lets providers know which claims are paid and whether there is any difference between the payment amount and the billed amount. This is a batch interface, with a real time option available in an upcoming version.

Current integrations include

DSG (Data Systems Group)
McKesson
Utah - Public Health Agencies

Incoming Benefit Enrollment and Maintenance (X12 834) read the spec

Receives enrollment information from employers or other sponsors of coverage. Health plans and employers send 834s to inform a payer about members who are being enrolled in the payer's insurance plan or for whom the payer is otherwise taking on risk.

Incoming Claim Status Inquiry (X12 276/277) read the spec

Receives requests from health care providers for status information about claims, including whether the claim was paid or unpaid and why. Tapestry supports the batch interface by default, with a real-time interface available. Returns response (X12 277).

Incoming Payment Order/Remittance Advice (X12 820 Batch) read the spec

Receives payment and remittance information. Tapestry supports an incoming 820 for the purpose of posting payment information against premium billing accounts.

Outgoing Benefit Enrollment and Maintenance (X12 834) read the spec

Sends enrollment information to health plans, government agencies, or other entities. Payers send 834s for reporting purposes to list all members for whom they have taken on risk.

Current integrations include

MedImpact
Navitus

Incoming Eligibility Verification Query (X12 270/271) read the spec

Receives requests from health care providers for member eligibility and benefits information in the form of a 270, and sends a response in the form of a 271. This is a real-time interface.

Current integrations include

Availity
Change Healthcare
HDX
Post-n-track
Relay Health
TransUnion

Incoming Referral Request for Review (X12 278R) read the spec

Receives a referral request from a provider or provider group so that Epic's managed care system can perform utilization management and approve or deny the service request. A response message is sent to inform the provider of the authorization decision.

Current integrations include

Johns Hopkins HealthCare LLC

Outgoing Unsolcited Healthcare Claim Pending Status Notification (X12 277P) read the spec

Sends information to a health care provider about the status of all non-finalized claims received from that provider. The 277P is an unsolicited message that is similar to the 277 response to the 276. It is sent so that the provider doesn't have to continually send 276 requests to the payer.

Current integrations include

Incoming Authorization Notification (X12 278N) read the spec

Receives unsolicited, completed referral information (usually with authorization numbers) from an external utilization management system so that Epic' Managed Care system can pay Accounts Payable (AP) claims. Sends an acknowledgment of the receipt of the information (or errors if any occur during message processing).

Current integrations include

Cigna
Evicore
Johns Hopkins HealthCare LLC
Magellan

Tapestry Incoming Referral Transfer Attachment (X12 275)

Receives electronic attachments and links them to claims in Epic's managed care product, Tapestry.

Current integrations include

MGC Diagnostics
Wolters Kluwer

Outgoing Eligibility Verification Query (X12 270/271) read the spec

Used to verify eligibility with clearinghouses and payers. Uses ANSI X12 270/271 transactions.

Current integrations include

3M
AccuReg
AmerisourceBergen
Arizona - Public Health Agencies
athenahealth
Availity
CareSource
Change Healthcare
Cigna
Clinical Computer Systems, Inc.
CMS
DECOS
E-Insights
Experian Health
ezVerify
FinThrive
HDX
Healthcare IP
Healthia
HealthNautica
Highmark
Humata Health
Inland Empire Health Plan
InstaMed, a J.P. Morgan Company
Jorie AI
Loxogon
MaxRTE
Medicaid
Moda
Navicure
NEBO
NEHEN
Ontario Ministry of Health
Optum
Pelitas
Post-n-track
Quadax
RealMed
Recondo
Relay Health
Rycan
Signify Health
Surescripts
The Advisory Board
The SSI Group
TransUnion
TriZetto Provider Solutions, a Cognizant Company
Trubridge
United Healthcare
Unspecified vendor(s) through open.epic
VisionShare
Waystar
WNY HealtheNet

Outgoing Claims Status Request (X12 276/277) read the spec

Sends requests and receives responses from payers and intermediary systems about claim statuses using industry standard ANSI ASC X12N 276/277 transactions. Epic uses web services to send and receive the X12 messages.

Current integrations include

Aetna
Anthem
Availity
Change Healthcare
Experian Health
FinThrive
Healthcare IP
HealthPartners
NEHEN
Optum
Quadax
SSi Healthcare
The SSI Group
TriZetto Provider Solutions, a Cognizant Company
Waystar

Outgoing Authorization Request for Review and Response (X12 278R) read the spec

Transmits patient referral or authorization information to a third-party system. The referral/authorization information is sent in order to obtain authorization for health care services (such as specialty referrals and procedures) with clearing houses and payers. It uses ANSI X12 278 transactions.

Current integrations include

AccuReg
Aetna
Allscripts
Anthem
athenahealth
Availity
Change Healthcare
Citra Health Solutions
Emblem
Ensemble Health Partners
Evicore
Experian Health
GE
Glidian
Health Care Service Corporation
Humana
Humata Health
Janus
Quartz
Recondo
Redox
Rhyme
Symplr
Texas - Public Health Agencies
United Healthcare
Voluware
Waystar

Outgoing Pharmacy Benefit Eligibility Query - 270/271 read the spec

E-Prescribing functionality when Epic is the Prescriber. Initiates pharmacy benefit eligibility queries.

Current integrations include

Availity
Cardinal Health WaveMark
Change Healthcare
Experian Health
MetroPlus
Surescripts

Outgoing Admission Notification (X12 278) read the spec

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
Janus
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

Outgoing Authorization Notification (X12 278N) read the spec

Sends authorization decisions for covered patient referrals to third-party AP claims systems. The response from the third-party AP claims system is the acknowledgement of the information received.

Current integrations include

Health Plan Services
Johns Hopkins HealthCare LLC
Natus
TriZetto Provider Solutions, a Cognizant Company
United Healthcare

Incoming Purchase Order Acknowledgement to Willow Inventory read the spec

Receives acknowledgements from a supplier for purchase orders placed in Willow Inventory. The interface uses the ANSI X12 855 transaction set for the response.

Current integrations include

Alliance Healthcare
AmerisourceBergen
Anda
Auburn Pharmaceutical
BD
Cardinal Health WaveMark
CenterX
Global Healthcare Exchange
Macro Helix
McKesson
Morris & Dickson
Oracle
Parmed
Surescripts
TopRx

Incoming Shipment Notification to Willow Inventory read the spec

Receives information about items sent by a supplier to fill a purchase order from Willow Inventory medication inventory management. This interface uses the ANSI X12 856 transaction set or European GS1.

Current integrations include

AmerisourceBergen
Anda
AutoMed
Baxter
BD
Cardinal Health WaveMark
CenterX
CuraScript
Global Healthcare Exchange
McKesson
Morris & Dickson
Oracle
Parmed
Surescripts
TopRx

Outgoing Health Care Claims for Institutional, Professional, and Dental Services read the spec

This outgoing batch interface sends insurance claim information to payers and intermediary systems using industry standard ANSI ASC X12N 837 transactions (institutional, professional and dental).

Current integrations include

Availity
Carisk Intelligent Clearinghouse
Change Healthcare
Cirius
ClaimLynx
efficientC
Experian Health
Healthcare IP
Inovalon
nThrive
Optum
Quadax
SSI
TriZetto Provider Solutions, a Cognizant Company
WayStar

Outgoing Health Care Data Reporting Claims read the spec

This outgoing batch interface sends insurance claim information to government and intermediary systems using the industry standard ANSI ASC X12N 837 data reporting transaction.

Rapid Retest read the spec

This bi-directional interface builds upon the use of standard Claim Reconciliation and sends individual claims to intermediary systems using industry standard ANSI ASC X12N 837 transactions (institutional, professional, and dental) and loads information about claim status back using industry standard ANSI ASC X12N 277 or 277CA transactions. This interface updates the status of errored claims in the system.

Current integrations include

Availity
Change Healthcare
Experian Health
Healthcare IP
nThrive
Quadax
The SSI Group
TriZetto Provider Solutions, a Cognizant Company
WayStar

Incoming Health Care Claim Payment/Advice read the spec

This incoming batch interface posts insurance claim payment information received directly from payers and content aggregators, such as claims clearinghouses and banks, using standard ANSI ASC X12N 835 transactions.

Current integrations include

Availity
Bank of America
BBVA
Change Healthcare
Cirius
ClaimLynx
efficientC
Experian Health
Fifth Third
Healthcare IP
Huntington Bank
Inovalon
J.P Morgan Chase
nThrive
Optum
Patientco
PNC
Quadax
Quadax
SSI
TD Bank, N.A.
Texas Capital Bank
TriZetto Provider Solutions, a Cognizant Company
US Bank
WayStar
Wells Fargo

Outgoing Health Care Claim Acknowledgement read the spec

This outgoing batch interface sends claim acknowledgement responses to incoming ANSI 837 files using ANSI ASC X12N 277CA transactions.

Tapestry Outgoing X12 Acknowledgment (X12 999) read the spec

This message is sent in response to incoming healthcare services messages. It acknowledges the receipt of the message and, if necessary, reports any formatting errors in the file. It is an ANSI ASC X12N 999 transaction.

Tapestry Outgoing Front-End Claim Status Acknowledgment (X12 277CA) read the spec

Tapestry Outgoing Front-End Claim Status Acknowledgment (X12 277CA).

Incoming Marketplace Benefit Enrollment and Maintenance (HIX 834) read the spec

Standard X12 format for loading marketplace information.

Incoming X12 HIX 820 read the spec

Incoming Standard X12 format for loading Marketplace Premium Payment Information.

Tapestry Outgoing Marketplace Benefit Enrollment (X12 834) read the spec

Standard X12 format for sending out marketplace coverage information

Outgoing Authorization Inquiry (X12 278I) read the spec

Provides the ability to inquire about the status of an existing authorization request. It uses ANSI X12 278 transactions and is used in conjunction with an Outgoing Authorization Request for Review - Outgoing Request (X12 278R) interface.

Current integrations include

Blue Cross/Blue Shield
Change Healthcare
Humana
Olive
Recondo
Relay Health
United Healthcare
WayStar

Incoming Claim Status Batch (X12 277) read the spec

This incoming batch interface loads information about claim status using industry standard ANSI ASC X12N 277 or 277CA transactions. This interface can update the status of claims in the system and is able to load claim error information from payer and intermediary systems.

X12 278 Endpoint Specifications read the spec

Describes JSON Wrapped RESTful endpoint for sending and receiving X12 278 interface messages.