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.

Eligibility Query

This bi-directional real-time query is used to verify eligibility with clearinghouses and payors. It uses ANSI X12 270/271 transactions.
Current integrations include...
  • AccuReg
  • Aetna
  • Anthem
  • Availity
  • Change Healthcare
  • Cigna
  • Experian Health
  • Gateway EDI
  • Group Health Cooperative (Seattle)
  • HDX
  • Health Alliance Plan
  • HealthCare Fiscal Management Inc.
  • Healthcare IP
  • HealthPartners
  • Highmark
  • InstaMed
  • Loxogon
  • MedAssets
  • Medicaid Minnesota
  • Medicaid New York
  • Medicaid Pennsylvania
  • Medicaid Texas
  • Medicaid Washington
  • Medicaid Wisconsin
  • Medicare
  • NEHEN
  • nThrive
  • Optima
  • Optum
  • Pelitas (formerly DCS Global)
  • Physicians Plus
  • Post-n-track Eligibility
  • Preferred One
  • Provider Advantage
  • Quadax
  • Recondo Technology
  • RelayHealth
  • Rycan
  • The Advisory Board Company
  • The SSI Group
  • TransUnion
  • Tricare
  • TriZetto Provider Solutions, a Cognizant Company
  • United Healthcare
  • Unity
  • UPMC Health Plan
  • VisionShare (ABILITY Network)
  • WayStar
  • WNY HealtheNet

Outgoing Admission Notification

This bidirectional X12 278 interface is used to notify a payor or health plan that a patient has been admitted. The request can be done real-time or in batches.
Current integrations include...
  • Aetna
  • Experian Health
  • Loxogon
  • HealthCareIP
  • Pelitas (formerly DCS Global)
  • Post-N-Track
  • United Healthcare

Outgoing Health Care Claims for Institutional, Professional, and Dental Services

This outgoing batch interface sends insurance claim information to payors and intermediary systems using industry standard ANSI ASC X12N 837 transactions (institutional, professional and dental).
Current integrations include...
  • ABILITY Network
  • Availity
  • Carisk Intelligent Clearinghouse
  • Change Healthcare
  • Cirius
  • ClaimLynx
  • Experian Health
  • Healthcare IP
  • nThrive
  • Optum
  • OS inc
  • Quadax
  • SSI
  • TriZetto Provider Solutions, a Cognizant Company
  • WayStar

Outgoing Health Care Data Reporting Claims

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

External Edit Management read the specRead the technical specs

This incoming batch interface loads information about claim status in a configurable flat file or ANSI ASC X12N 277 or 277CA format. This interface can update the status of claims in the system and is able to load claim error information from payor and intermediary systems.

The flat file format is configurable, but the above common specification is pre-configured in the Foundation System for Epic customers and widely used with success.
Current integrations include...
  • Availity
  • Cirius
  • Change Healthcare
  • Experian Health
  • Healthcare IP
  • InstaMed
  • nThrive
  • Optum
  • Quadax
  • SSI
  • TriZetto Provider Solutions, a Cognizant Company
  • WayStar

Rapid Retest

This bi-directional interface builds upon the use of standard Claim Reconciliation 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. See also our requirements for clearinghouse vendors supporting rapid retest.
Current integrations include...
  • Availity
  • Change Healthcare
  • Experian Health
  • Healthcare IP
  • nThrive
  • The SSI Group
  • TriZetto Provider Solutions, a Cognizant Company
  • WayStar

Incoming Claim Acknowledgement

This incoming interface loads claim acknowledgement responses using industry standard ANSI ASC X12N 277CA, 999/997/TA1 or 277U transactions.
Current integrations include...
  • Availity
  • Change Healthcare
  • Cirius
  • ClaimLynx
  • Experian Health
  • Healthcare IP
  • nThrive
  • Optum
  • OS inc
  • Quadax
  • Recondo
  • SSI
  • TriZetto Provider Solutions, a Cognizant Company
  • WayStar

Payer Status Query

This bi-directional real-time interface sends requests and receives responses from payors 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...
  • Availity
  • Change Healthcare
  • Experian Health
  • SSI
  • TriZetto Provider Solutions, a Cognizant Company

Incoming Health Care Claim Payment/Advice

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...
  • ABILITY Network
  • Availity
  • Bank of America
  • BBVA
  • Change Healthcare
  • Chase
  • Cirius
  • ClaimLynx
  • Experian Health
  • Fifth Third
  • Healthcare IP
  • nThrive
  • Optum
  • OS inc
  • Patientco
  • PNC
  • Quadax
  • SSI
  • TriZetto Provider Solutions, a Cognizant Company
  • US Bank
  • WayStar
  • Wells Fargo

Benefit Enrollment and Maintenance

Tapestry receives incoming enrollment information from employers or other sponsors of coverage through batched ANSI ASC X12N 834 transactions. Similarly, it sends enrollment information to entities needing the information through the same standards.

Eligibility, Coverage, or Benefit Inquiry

This bi-directional real-time interface receives and responds to inquiries about a member's eligibility and benefits. It uses ANSI ASC X12N 270/271 transactions. Epic exposes Web services to send and receive the X12 messages.

Health Care Services Review

This bi-directional real-time interface receives and responds to new referral requests. It uses ANSI ASC X12N 278/278 transactions. Similarly, Tapestry can provide unsolicited ANSI 278 notifications for single referrals.

Health Care Claim Status

This bi-directional real-time interface receives requests and sends responses to healthcare providers about claim statuses. ANSI ASC X12N 276/277 transactions are used. Epic exposes Web services to send and receive the X12 messages.

Incoming Health Care Claims for Institutional and Professional Services

Tapestry receives institutional and professional claims in batch from healthcare providers through ANSI ASC X12N 837 transactions. It sends claims in batch to payors using the same standard. Tapestry can also receive dental claims using this standard.

Outgoing Health Care Claim Acknowledgement

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

Outgoing Health Care Services Functional Acknowledgement

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.

Incoming Payment Order/Remittance Advice - 820

This incoming batch interface receives health insurance premium payment information using ANSI ASC X12N 820 transactions.

Outgoing Health Care Claim Remittance Advice

This outgoing batch interface contains claim payment information for health care providers. It uses ANSI ASC X12N 835 transactions. Batches can be provided via Web services exposed by Epic software.

Claims Editing

This bidirectional interface is used for claim code editing.
Current integrations include...
  • OptumInsight iCES
  • McKesson CodeReview (in progress for ClaimsXten)

Outgoing Health Care Services Review Request and Response - X12 read the specRead the technical specs

This interface 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 payors. It uses ANSI X12 278 transactions.
Current integrations include...
  • Experian Health
  • HealthCareIP

Outgoing Pharmacy Benefit Eligibility Query - 270/271

This bi-directional real-time query is used to verify eligibility with clearinghouses and payors. It uses ANSI X12 270/271 transactions.
Current integrations include...
  • AccuReg
  • Aetna
  • Anthem
  • Availity
  • Change Healthcare
  • Cigna
  • Experian Health
  • Gateway EDI
  • Group Health Cooperative (Seattle)
  • HDX
  • Health Alliance Plan
  • HealthCare Fiscal Management Inc.
  • Healthcare IP
  • HealthPartners
  • Highmark
  • InstaMed
  • Loxogon
  • MedAssets
  • Medicaid Minnesota
  • Medicaid New York
  • Medicaid Pennsylvania
  • Medicaid Texas
  • Medicaid Washington
  • Medicaid Wisconsin
  • Medicare
  • NEHEN
  • nThrive
  • Optima
  • Optum
  • Pelitas (formerly DCS Global)
  • Physicians Plus
  • Post-n-track Eligibility
  • Preferred One
  • Provider Advantage
  • Quadax
  • Recondo Technology
  • RelayHealth
  • Rycan
  • The Advisory Board Company
  • The SSI Group
  • TransUnion
  • Tricare
  • TriZetto Provider Solutions, a Cognizant Company
  • United Healthcare
  • Unity
  • UPMC Health Plan
  • VisionShare (ABILITY Network)
  • WayStar
  • WNY HealtheNet

Health Care Services Authorization Notification - 275/275 (bi-directional)

Sends and receives additional information corresponding to an outgoing 278/278 authorization notification. The 275 is for information that is not in the 278 standard.

Outgoing Health Care Claim Pending Status Notification - 277P3

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 payor.

Incoming Shipment Notification to Willow Inventory read the specRead the technical specs

Receives information about items sent by a supplier to fulfill purchase orders placed in Willow Inventory. This interface uses the ANSI X12 856 transaction set or GS1.

Outgoing Pharmacy Purchase Order from Willow Inventory read the specRead the technical specs

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

Incoming Purchase Order Acknowledgement to Willow Inventory read the specRead the technical specs

The standard ANSI X12 Incoming Purchase Order Acknowledgement Interface is used for receiving acknowledgements from a supplier for purchase orders placed in Willow Inventory. The interface uses the ANSI X12 855 transaction set for the response.

Incoming Pharmacy Purchase Order Invoice to Willow Inventory read the specRead the technical specs

The standard ANSI X12 Incoming Purchase Order Invoice Interface is used for receiving invoices from a supplier for purchase orders placed in Willow Inventory. The interface uses the ANSI X12 810 transaction set for the response.