Transactions & Specifications

Eligibility Benefit Inquiry and Response (270/271)

The 270/271 transactions are handled through CMS. For more information, click here

Claim Status Request and Response (276/277)

Jurisdiction B DME MAC batch claim status request and response must be submitted and received through the Common Electronic Data Interchange (CEDI) using the HIPAA compliant ANSI 4010A1 X12N 276/277 transaction. This implementation guide is available at the Washington Publishing Company web site: www.wpc-edi.com

276/277 Companion Document

Companion Document to the HIPAA ANSI X12N 276/277 implementation guide. Used for clarification purposes.

Electronic Remittance Advice (835)

Jurisdiction B DME MAC remittances are sent using the HIPAA compliant ANSI 4010A1 X12N 835 transaction. The Electronic Remittance Advices are delivered by CEDI. This implementation guide is available at the Washington Publishing Company web site: www.wpc-edi.com

835 Companion Document

Companion Document to the HIPAA ANSI X12N 835 implementation guide. Used for clarification purposes.

Inbound Claims (837)  

Jurisdiction B DME MAC claims must be submitted through CEDI using the HIPAA compliant ANSI 4010A1 X12N 837 transaction. This implementation guide is available at the Washington Publishing Company web site: www.wpc-edi.com

837 Companion Document

Companion Document to the HIPAA ANSI X12N 837 implementation guide. Used for clarification purposes.

National Council for Prescription Drugs Program (NCPDP)

Jurisdiction B DME MAC retail pharmacy drug claims must be submitted through CEDI using the National Council for Prescription Drugs Program (NCPDP) format. This implementation guide is available at www.ncpdp.org

NCPDP Companion Document

Companion Document to the HIPAA ANSI X12N NCPDP implementation guide. Used for clarification purposes.