What is an 834 EDI document?

Put as simply as possible, an Electronic Data Interchange (EDI) 834 file is the standard format in which employers can communicate their employees’ health insurance enrollment and maintenance data to insurance carriers.

What is a Hipaa 834 transaction?

HIPAA 834 refers to the file format of an electronic transaction. HIPAA 834 is the specific format that employers must use when they electronically communicate employee health insurance benefit enrollment and maintenance data to employee health plans.

What does 834 file contain?

The 834 file includes demographic information on the employee, including the plan subscriber’s name, plan network information, eligibility and benefit information. For third-party administrators, an EDI 843 file is commonly used to add, remove or update member’s enrollment information.

What is 834 companion guide?

The X12N 834 version of the 5010 Standards for Electronic Data Interchange Technical Report Type 3 and Errata (also referred to as Implementation Guides) for the Benefit Enrollment and Maintenance has been established as the standard for Health Care enrollment and maintenance transaction compliance.

What is an 834 transaction set?

The EDI 834 transaction set represents a Benefit Enrollment and Maintenance document. It is used by employers, as well as unions, government agencies or insurance agencies, to enroll members in a healthcare benefit plan. Reinstatement of a member’s benefit enrollment.

What does health insurance eligibility mean?

Eligibility Date: The date on which a person becomes eligible for insurance benefits. A dependent (usually spouse or child) of an insured person who is eligible for insurance coverage. Eligible Employee: An employee who is eligible for insurance coverage based upon the stipulations of the group health insurance plan.

What are the different EDI file formats?

EDI standards include SWIFT (banking), TRADACOMS (UK specific) and VDA (a standard format specific to the German automotive industry). Flat files, XML, EDI you know, now, all about the different types of files that make it possible to exchange information electronically.

Which loop segment has the member detail in the 834 transaction?

loop 2000
The 834 transaction provides the capability to terminate a member at either the Member Detail INS level (loop 2000) or at the Health Coverage HD level (loop 2300).

What is a benefit inquiry?

The eligibility/benefit inquiry transaction is used to obtain information about a benefit plan for an enrollee, including information on eligibility and coverage under the health plan. This inquiry can be sent from a health care provider to a health plan, or from one health plan to another.

What does 834 ID mean?

834 is a number with a symbolic numerology. This also has number 8 as the starting digit. It means simultaneous growth. It is growing in levels.

How does using EDI facilitate electronic transactions?

EDI is used for electronic funds transfer (EFT) between financial institutions, which facilitates such common transactions as the direct deposit of payroll checks by employers, the direct debit of consumer accounts to make mortgage or utility payments, and the electronic payment of federal taxes by businesses.

What is EDI transaction?

EDI transactions are a type of electronic commerce that companies use for transactions such as when one company wants to electronically send a purchase order to another. EDI transactions were designed to be independent of the communications used by companies or the software technology that generates the EDI data.