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.

Outgoing Authorization Inquiry (X12 278I) read the specOutgoing Authorization Inquiry (X12 278I) technical specification

Sends inquiries to clearinghouses and payers about existing authorization information for a patient and receives responses to those inquiries. Inquiries can originate from the referring organization, or from the referred to organization. This interface is often used in conjunction with the Outgoing Health Care Services Authorization Request - 278/278 interface.
Current integrations include
  • Blue Cross/Blue Shield
  • Change Healthcare
  • Humana
  • Humata Health
  • Janus
  • Recondo
  • Relay Health
  • United Healthcare
  • Waystar

Incoming Healthcare Claim Repricing Request (X12 837) read the specIncoming Healthcare Claim Repricing Request (X12 837) technical specification

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.

Incoming Pharmacy Price Sales Catalog to Willow Inventory Interface read the specIncoming Pharmacy Price Sales Catalog to Willow Inventory Interface technical specification

Updates purchase contract records with up-to-date pricing and supplier item ID information.
Current integrations include
  • Anda
  • BD
  • Cardinal Health WaveMark
  • McKesson
  • Morris & Dickson
  • Swisslog

Outgoing Additional Information to Support a Health Care Services Authorization Query read the specOutgoing Additional Information to Support a Health Care Services Authorization Query technical specification

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
  • Voluware

Incoming Claim File Acknowledgment Interface – 999 read the specIncoming Claim File Acknowledgment Interface – 999 technical specification

This incoming interface loads claim file acknowledgment responses using industry standard ANSI ASC X12N 999 transactions.
Current integrations include
  • 3M
  • Cigna
  • FinThrive
  • Optum

Outgoing Authorization Request as Notification - 278R read the specOutgoing Authorization Request as Notification - 278R technical specification

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 Additional Information for Health Care Claim - 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.

Outgoing Additional Information for Health Care Claim - 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 specOutgoing Pharmacy Purchase Order from Willow Inventory technical specification

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
  • Baxter
  • BD
  • Cardinal Health WaveMark
  • CenterX
  • CuraScript
  • E.Novation
  • Global Healthcare Exchange
  • Infor Global Solutions
  • McKesson
  • Mediq
  • Morris & Dickson
  • Oracle
  • Parata
  • Parmed
  • River City Pharma
  • TopRx

Incoming Pharmacy Purchase Order Invoice to Willow Inventory read the specIncoming Pharmacy Purchase Order Invoice to Willow Inventory technical specification

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
  • AutoMed
  • Baxter
  • BD
  • Cardinal Health WaveMark
  • CenterX
  • Global Healthcare Exchange
  • Macro Helix
  • McKesson
  • Morris & Dickson
  • Oracle
  • Parmed
  • TopRx

Outgoing Healthcare Claim: Professional (X12 837 Batch) read the specOutgoing Healthcare Claim: Professional (X12 837 Batch) technical specification

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 Batch) read the specIncoming Healthcare Claim: Professional (X12 837 Batch) technical specification

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

Outgoing Healthcare Claim Payment/Advice (X12 834 Batch) read the specOutgoing Healthcare Claim Payment/Advice (X12 834 Batch) technical specification

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.
Current integrations include
  • DSG (Data Systems Group)
  • McKesson
  • Utah - Public Health Agencies

Incoming Benefit Enrollment and Maintenance (X12 834 Batch) read the specIncoming Benefit Enrollment and Maintenance (X12 834 Batch) technical specification

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) read the specIncoming Claim Status Inquiry (X12 276) technical specification

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.
Current integrations include
  • Change Healthcare
  • Tridiuum

Incoming Payment Order/Remittance Advice (X12 820 Batch) read the specIncoming Payment Order/Remittance Advice (X12 820 Batch) technical specification

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 Batch) read the specOutgoing Benefit Enrollment and Maintenance (X12 834 Batch) technical specification

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.

Incoming Eligibility Verification Query (X12 270/271) read the specIncoming Eligibility Verification Query (X12 270/271) technical specification

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 - 278R read the specIncoming Referral Request for Review - 278R technical specification

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.

Outgoing Unsolcited Healthcare Claim Pending Status Notification (X12 277P) read the specOutgoing Unsolcited Healthcare Claim Pending Status Notification (X12 277P) technical specification

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 Authorization Notification - 278N read the specIncoming Authorization Notification - 278N technical specification

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
  • Magellan

Outgoing Eligibility Verification Query read the specOutgoing Eligibility Verification Query technical specification

Used to verify eligibility with clearinghouses and payers. Uses ANSI X12 270/271 transactions.
Current integrations include
  • 3M
  • AccuReg
  • Allscripts
  • Arizona - Public Health Agencies
  • athenahealth
  • Availity
  • CareSource
  • Change Healthcare
  • Cigna
  • Clinical Computer Systems, Inc.
  • DECOS
  • Experian Health
  • Fidelis Care
  • FinThrive
  • HDX
  • Health Resources and Services Administration
  • HealthCare Fiscal Management
  • Healthcare IP
  • Healthia
  • HealthNautica
  • Highmark
  • Humata Health
  • Inland Empire Health Plan
  • InstaMed, a J.P. Morgan Company
  • Loxogon
  • Medicaid
  • Moda
  • Navicure
  • NEBO
  • NEHEN
  • Ontario Ministry of Health
  • Optum
  • Pelitas
  • Post-n-track
  • Quadax
  • RealMed
  • Recondo
  • Relay Health
  • Rycan
  • Signify Health
  • Smart Data Solutions
  • Surescripts
  • The Advisory Board
  • The SSI Group
  • TransUnion
  • TriZetto Provider Solutions, a Cognizant Company
  • United Healthcare
  • Unspecified vendor(s) through open.epic
  • VisionShare
  • Waystar
  • WNY HealtheNet

Outgoing Claims Status Request 276/277 read the specOutgoing Claims Status Request 276/277 technical specification

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
  • The SSI Group
  • TriZetto Provider Solutions, a Cognizant Company
  • Waystar

Outgoing Authorization Request for Review and Response (X12 278R) read the specOutgoing Authorization Request for Review and Response (X12 278R) technical specification

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
  • Clinical Computer Systems, Inc.
  • Emblem
  • Evicore
  • Experian Health
  • GE
  • Glidian
  • HCS
  • Humana
  • Humata Health
  • McKesson
  • Quartz
  • Recondo
  • Redox
  • Rhyme
  • Symplr
  • Texas - Public Health Agencies
  • Voluware
  • Waystar

Outgoing Pharmacy Benefit Eligibility Query - 270/271 read the specOutgoing Pharmacy Benefit Eligibility Query - 270/271 technical specification

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 read the specOutgoing Admission Notification 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
  • Healthcare IP
  • Horizon
  • Humana
  • Humata Health
  • 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 - 278N read the specOutgoing Authorization Notification - 278N technical specification

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
  • Natus
  • TriZetto Provider Solutions, a Cognizant Company
  • United Healthcare

Incoming Purchase Order Acknowledgement to Willow Inventory read the specIncoming Purchase Order Acknowledgement to Willow Inventory technical specification

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
  • Cardinal Health WaveMark
  • CenterX
  • Macro Helix
  • McKesson
  • Morris & Dickson
  • Oracle
  • Parmed

Incoming Shipment Notification to Willow Inventory read the specIncoming Shipment Notification to Willow Inventory technical specification

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
  • TopRx

Outgoing Health Care Claims for Institutional, Professional, and Dental Services read the specOutgoing Health Care Claims for Institutional, Professional, and Dental Services technical specification

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 specOutgoing Health Care Data Reporting Claims technical specification

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 specRapid Retest  technical specification

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 specIncoming Health Care Claim Payment/Advice technical specification

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 specOutgoing Health Care Claim Acknowledgement technical specification

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 specTapestry Outgoing X12 Acknowledgment (X12 999) technical specification

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 specTapestry Outgoing Front-End Claim Status Acknowledgment (X12 277CA) technical specification

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

Incoming Marketplace Benefit Enrollment and Maintenance (HIX 834) read the specIncoming Marketplace Benefit Enrollment and Maintenance  (HIX 834) technical specification

Standard X12 format for loading marketplace information.

Incoming X12 HIX 820 read the specIncoming X12 HIX 820 technical specification

Incoming Standard X12 format for loading Marketplace Premium Payment Information.

Tapestry Outgoing Marketplace Benefit Enrollment (X12 834) read the specTapestry Outgoing Marketplace Benefit Enrollment (X12 834) technical specification

Standard X12 format for sending out marketplace coverage information

Outgoing Referral Inquiry (X12 278I) read the specOutgoing Referral Inquiry (X12 278I) technical specification

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 Referral 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 specIncoming Claim Status Batch (X12 277) technical specification

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.