Premium Payment Standard v3

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UHIN Standard Premium Payment is compatible with all HIPAA requirements.

Purpose:  The purpose of this Standard is to detail the Standard transactions for the transmission of Premium Payments in the state of Utah.

Applicability:  This Standard applies to all premium payment transactions sent to payers.

Detail:

  1. Standard Premium Payment transaction:

The UHIN Standard for Premium Payment transaction is the HIPAA ASC X12 820 005010X218 Benefits Premium Payment.

See the Washington Publishing Company web site (http://www.wpc-edi.com) to purchase a copy of the implementation guide.

  1. There is no standard response to the Premium Payment transaction that can be used to identify problems with the data.
  2. Because there is no national standard response to the Premium Payment transaction, many data issues may be handled by non EDI communications

 

IMPLEMENTATION ISSUE:

  1. For plans in need of a rate code for payment reconciliation, the rate can be sent in Loop 2300B Individual Premium Remittance Detail

REF02 where REF01 = ZZ

  1. An acknowledgement response can be determined by Trading Partner Agreement.

 

 

 

Version 1

 

 

 

 

 

ORIGINATION DATE

02/09/10

 

 

 

 

 

APPROVAL DATE

02/02/2011

 

 

 

 

 

EFFECTIVE DATE

03/02/2011

 

 

 

 

 

 

 

Click below to download a copy of this document. 

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