HealthChoice to offer new EDI services


Posted On: 1/02/2014


Oklahoma’s HealthChoice plan is now offering electronic Eligibility Benefit Request and Response (270 request/271 response) transactions and Health Care Claim Status Request and Response (276 request/277 response) transactions.  

The 270/271 transaction allows providers to determine whether a particular subscriber or dependent is on file with the health plan, and the health care eligibility and/or benefit information about that subscriber and/or dependent. It is used to verify an individual’s eligibility and benefits, but cannot provide a history of benefit use.

The 276/277 transaction is used to obtain the status of specific health care claims(s) within the adjudication process. Like the 270/271, these transactions are communications between the computer systems of providers and the plan.

HealthChoice is also now offering the 835 Health Care Claim Payment and Remittance Advice (Electronic Remittance Advice) transaction set to providers.

For more information, and to sign up for these Electronic Data Interchange transactions, see:

www.ok.gov/sib/Providers/Eligibility_Benefit_Request_and_Response_270-271.html
www.ok.gov/sib/Providers/HealthCare_Claim_Status_Request_and_Response_276_277.html
www.ok.gov/sib/Providers/Electronic_Remittance_Advice_(ERA)/index.html
(Rick Snyder)

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