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 External Pre-adjudicated Claims - 837

Processes pre-adjudicated 837 claim data for the purposes of reporting within a Clinically Integrated Network (CIN). Does not integrate with Epic's billing systems.

Tapestry Incoming Health Care Claim: Repricing Request - 837 read the specRead the technical specs

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

Incoming External Paid Medical Claims Interface - 837

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

Outgoing Additional Information to Support a Health Care Services Authorization Query

Used in conjunction with an Outgoing Health Care Services Authorization Query - 278, 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)

Incoming Claim File Acknowledgment Interface – 999

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

Outgoing Pharmacy Purchase Order from Willow Inventory

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
  • AutoMed
  • BD
  • Cardinal Health
  • CenterX
  • CuraScript
  • McKesson
  • Mediq
  • Morris & Dickson
  • Oracle
  • Parata
  • Parmed
  • River City Pharma
  • Thrifty White

Incoming Pharmacy Purchase Order Invoice to Willow Inventory

Receives invoices from a supplier for purchase orders placed in Willow Inventory, medication inventory management system. The interface uses the ANSI X12 810 transaction set for the response.
Current integrations include...
  • Alliance Healthcare
  • AmerisourceBergen
  • Anda
  • Cardinal Health
  • CenterX
  • Macro Helix
  • McKesson
  • Morris & Dickson
  • Parmed

Health Care Claims - Incoming 837 read the specRead the technical specs

Tapestry receives incoming professional, institutional, or dental claims through ANSI ASC X12 837 transactions.
Current integrations include...
  • Availity
  • DSG (Data Systems Group)
  • McKesson
  • Smart Data Solutions
  • Waystar

Outgoing Health Care Claim Remittance Advice - 835 read the specRead the technical specs

Sends claim payment and/or 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.
Current integrations include...
  • DSG (Data Systems Group)
  • McKesson

Incoming Benefit Enrollment and Maintenance - 834 read the specRead the technical specs

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 Health Care Claim Status - 276/277 read the specRead the technical specs

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.

Incoming Payment Order/Remittance Advice - 820 read the specRead the technical specs

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

Tapestry Outgoing Benefit Enrollment and Maintenance - 834 read the specRead the technical specs

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

Incoming Eligibility, Coverage, or Benefit Inquiry - 270/271 read the specRead the technical specs

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...
  • Change Healthcare
  • HDX
  • Post-n-track
  • Relay Health

Incoming Health Care Services Review - 278/278 read the specRead the technical specs

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

Outgoing Health Care Claim Pending Status Notification - 277P read the specRead the technical specs

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.

Incoming Health Care Services Authorization Notification (Health Plan) - 278/278 (Bidirectional) read the specRead the technical specs

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).

Outgoing Eligibility Verification Query

Used to verify eligibility with clearinghouses and payers. Uses ANSI X12 270/271 transactions.
Current integrations include...
  • AccuReg
  • Allscripts
  • Anthem
  • Arizona Department of Health Services
  • Athena Health
  • Availity
  • Change Healthcare
  • Cigna
  • Experian Health
  • HDX
  • HealthCare Fiscal Management
  • Healthcare IP
  • Healthia
  • Highmark
  • InstaMed
  • Loxogon
  • Medicaid
  • Moda
  • Navicure
  • NEBO
  • NEHEN
  • nThrive
  • Ontario Ministry of Health
  • Optum
  • Pelitas
  • Post-n-track
  • Quadax
  • RealMed
  • Recondo
  • Relay Health
  • Rycan
  • Search America
  • Smart Data Solutions
  • Surescripts
  • The Advisory Board
  • The SSI Group
  • TransUnion
  • TriZetto Provider Solutions, a Cognizant Company
  • UnitedHealthcare
  • VisionShare
  • Waystar
  • WebMD
  • WNY HealtheNet

Outgoing Claims Status Request 276/277 read the specRead the technical specs

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
  • Availity
  • Change Healthcare
  • Experian Health
  • NEHEN
  • nThrive
  • Optum
  • Quadax
  • The SSI Group
  • TriZetto Provider Solutions, a Cognizant Company
  • Waystar

Outgoing Referral Request for Review - 278R read the specRead the technical specs

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...
  • Aetna
  • Allscripts
  • Anthem
  • Athena Health
  • Availity
  • Change Healthcare
  • Conduent
  • Emblem
  • Evicore
  • Experian Health
  • GE
  • Humana
  • Morrisey
  • Optum
  • Quartz
  • Recondo
  • Relay Health
  • UnitedHealthcare

Outgoing Pharmacy Benefit Eligibility Query - 270/271 read the specRead the technical specs

E-Prescribing functionality when Epic is the Prescriber. Initiates pharmacy benefit eligibility queries.
Current integrations include...
  • Cardinal Health
  • Experian Health
  • Surescripts

Outgoing Admission Notification read the specRead the technical specs

Used to notify a payor 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 payor 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
  • Experian Health
  • Healthcare IP
  • Horizon
  • Medicaid
  • Optum
  • Pelitas
  • Post-n-track
  • Quartz
  • Relay Health
  • The Advisory Board
  • UnitedHealthcare

Outgoing Health Care Services Authorization Notification - 278/278

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...
  • TriZetto Provider Solutions, a Cognizant Company

Incoming Purchase Order Acknowledgement to Willow Inventory

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.
Current integrations include...
  • Alliance Healthcare
  • AmerisourceBergen
  • Anda
  • Cardinal Health
  • CenterX
  • Macro Helix
  • McKesson
  • Morris & Dickson
  • Oracle
  • Parmed
  • Thrifty White

Incoming Shipment Notification to Willow Inventory

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
  • BD
  • Cardinal Health
  • CenterX
  • CuraScript
  • McKesson
  • Morris & Dickson

Outgoing Health Care Claims for Institutional, Professional, and Dental Services read the specRead the technical specs

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...
  • 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 read the specRead the technical specs

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 specRead the technical specs

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.
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 specRead the technical specs

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...
  • Quadax
  • 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
  • TD Bank, N.A.
  • TriZetto Provider Solutions, a Cognizant Company
  • US Bank
  • WayStar
  • Wells Fargo

Outgoing Health Care Claim Acknowledgement read the specRead the technical specs

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 read the specRead the technical specs

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 277CA Claim Acknowledgements read the specRead the technical specs

Incoming Standard X12 format for loading Claim Acknowledgements.

Incoming Marketplace Benefit Enrollment and Maintenance (HIX 834) read the specRead the technical specs

Standard X12 format for loading marketplace information.

Incoming X12 HIX 820 read the specRead the technical specs

Incoming Standard X12 format for loading Marketplace Premium Payment Information.

Outgoing Additional Information for Health Care Services Authorization Notification - 275/275 (Bidirectional)

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 Marketplace Benefit Enrollment and Maintenance (HIX 834) read the specRead the technical specs

Standard X12 format for sending out marketplace coverage information

Real-time 837 External Pricing read the specRead the technical specs

Tapestry supports pricing claims in real-time by sending the 837 and receiving a response of a repriced 837 with HCP Segments.