Transaction Standards in the Dental OfficeA few weeks ago, I blogged about the Electronic Remittance Advice (ERA) and how your practice could benefit from its use.
Here’s a list of transactions that you should care about in your practice and their 3-digit ANSI identifier:
| 270 | Eligibility or benefit inquiry |
| 271 | Eligibility or benefit response |
| 276 | Healthcare claim status inquiry |
| 277 | Healthcare claim status response |
| 835 | Remittance/payment advice |
| 837 | Healthcare claim |
The 270/271 (eligibility inquiry and response) allows you to determine a patient’s insurance eligibility. This exchange takes only a few seconds and you are often given not only their eligibility status, but a summary of the patient’s benefits as well.
The 276/277 (claims status inquiry and response) is similar to the 270/271 but is asking the insurance company for the status of a particular claim. Both transactions eliminate the need to call the carrier and transcribe the information you get over the phone.
The 835 (remittance advice) offers the benefits I’ve previously blogged about while the electronic claim (837) is now a standard practice in most dental offices. A major insurer in Oregon is mandating that you can only submit electronic claims and they will only respond with an electronic remittance and an EFT (Electronic Funds Transfer).
My post on “Connected Dentistry” says that more and more of these exchanges are in the future for the dental office. Being prepared to utilize the appropriate transaction standards will lessen the complexity in your practice and lower your blood pressure.
Just like that German pilot navigating across many countries on his way to a final destination, standards make it all work and are definitely a right click.
