275 Claim Attachment Transactions via EDI 

 Electronic Attachments (275 transactions) are supplemental documents providing additional patient medical information to the payer that cannot be accommodated within the ANSI ASC X12, 837 claim format. Common attachments are certificates of medical necessity (CMNs), discharge summaries, and operative reports to support a healthcare claim adjudication.

 

 

There are two cases of EDI 275 as follows:

1) Solicited 275 Transaction: Provider receives a 277R response from the payer, requesting additional information. Provider submits a 275.

2) Unsolicited 275 Transaction: Provider submits supplemental information on a pre-adjudicated claim submission that is not required on the actual submission but will    
  Assist the payer in determining accurate benefits during the adjudication process. 

 

When to Submit ?
The payer requests supporting documentation for a claim.
The provider proactively sends additional clinical data to support a claim (EDI 837P/ EDI 837I /r EDI 837D) or authorization.

 

How to attach document in EDI 275 Message ?

All attachment information must be MIME-packaged

A sample MIME encoded attachment format:

MIME-Version: 1.0
Content-Type: image/tiff
Content-Transfer-Encoding: base64
Content-Disposition: attachment; filename="patientxray.tif" 
<Base64 encoded data>


Mime-Version: 1.0
Content-Type: application/pdf
Content-Transfer-Encoding: base64
Content-Disposition: attachment; filename=GS.TSOF36E.275AT20180501452_001_1525194905295_189410.pdf
<BASE64 STRING>~


To create the attachment file for the 275 messages, we first need to convert the file to Base64 encoding characters.

The following file types are supported:
• Acrobat (pdf)
• Bitmap (bmp)
• Graphic interchange format (gif)
• JPEG image (jpg)
• Portable network graphics (png)
• Tagged Image File (tif)
• XML text (ex: CDA)
 

 

How the payer will process our Unsolicited 275 Transaction

 


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


 

Sample EDI 275 Claim Attachment

 ISA*00*          *00*          *ZZ*111134         *01*zirmed         *200219*0749*^*00501*796000000*0*P*:

GS*PI*111134*zirmed*20200219*0749*796*X*005010X210

ST*275*1234*005010X210

BGN*02*1000*20180514

NM1*PR*2*XYZ Insurance*****PI*21231

NM1*41*2*Demo Practice*****46*111134

NM1*1P*1*JOHN*MUFFY*M**M.D*XX*123456789

NX1*1P

N3*PO BOX 123*157 WEST 57TH STREET

N4*CINCINNATI*OH*43017

NM1*QC*1*CARROL*JENNIFER*T**PH.D*MI*9012345918341

REF*EJ*1231232

REF*EA*9999999

REF*D9*1212323

LX*1

TRN*1*123123

DTP*368*D8*20180514

CAT*AE*MB

EFI*05

BIN*1097*Mime-version: 1.0

Content-Type: application/pdf

Content-Transfer-Encoding: base64

Content-Disposition: attachment; filename=right_arm-pictures.pdf


JVBERi0xLjcKCjQgMCBvYmoKPDwKL0JpdHNQZXJDb21wb25lbnQgOAovQ29sb3JTcGFjZSAvRGV2aWNlUkdCCi9GaWx0ZXIgL0RDVERlY29kZQovSGVpZ2h0IDE3OAovTGVuZ3RoIDkzNDIKL1N1YnR5cGUgL0ltYWdlCi9UeXBlIC9YT2JqZWN0Ci9XaWR0aCA0ODkKPj4Kc3RyZWFtCv/Y/+AAEEpGSUYA

SE*19*1234

GE*1*796

IEA*1*796000000




 

One claim with two attachments example

 

 ISA*00*          *00*          *ZZ*111134         *01*zirmed         *200219*0749*^*00501*796000000*0*P*:

GS*PI*111134*zirmed*20200219*0749*796*X*005010X210

ST*275*5312*005010X210

BGN*02*1000*20180514

NM1*PR*2*XYZ Insurance*****PI*21231

NM1*41*2*Demo Practice*****46*111134

NM1*1P*1*JOHN*MUFFY*M**M.D*XX*123456789

NX1*1P

N3*PO BOX 123*157 WEST 57TH STREET

N4*CINCINNATI*OH*43017

NM1*QC*1*CARROL*JENNIFER*T**PH.D*MI*9012345918341

REF*EJ*1231232

REF*EA*9999999

REF*D9*1212323

LX*1

TRN*1*123123

DTP*368*D8*20180514

CAT*AE*MB

EFI*05

BIN*1097*Mime-version: 1.0

Content-Type: application/pdf

Content-Transfer-Encoding: base64

Content-Disposition: attachment; filename=right_arm-pictures.pdf


JVBERi0xLjcKCjQgMCBvYmoKPDwKL0JpdHNQZXJDb21wb25lbnQgOAovQ29sb3JTcGFjZSAvRGV2aWNlUkdCCi9GaWx0ZXIgL0RDVERlY29kZQovSGVpZ2h0IDE3OAovTGVuZ3RoIDkzNDIKL1N1YnR5cGUgL0ltYWdlCi9UeXBlIC9YT2JqZWN0Ci9XaWR0aCA0ODkKPj4Kc3RyZWFtCv/Y/+AAEEpGSUYA

LX*2

TRN*1*52412

DTP*368*D8*20180514

CAT*AE*MB

EFI*05

BIN*2097*Mime-version: 1.0

Content-Type: application/pdf

Content-Transfer-Encoding: base64

Content-Disposition: attachment; filename=left_arm-pictures.pdf


JVBERi0xLjcKCjQgMCBvYmoKPDwKL0JpdHNQZXJDb21wb25lbnQgOAovQ29sb3JTcGFjZSAvRGV2aWNlUkdCCi9GaWx0ZXIgL0RDVERlY29kZQovSGVpZ2h0IDE3OAovTGVuZ3RoIDkzNDIKL1N1YnR5cGUgL0ltYWdlCi9UeXBlIC9YT2JqZWN0Ci9XaWR0aCA0ODkKPj4Kc3RyZWFtCv/Y/+AAEEpGSUYA

SE*25*5312

GE*1*796

IEA*1*796000000


Multiple claims in EDI 275 Message

ISA*00*          *00*          *ZZ*111134         *01*zirmed         *200219*0749*^*00501*796000000*0*P*:
GS*PI*111134*zirmed*20200219*0749*796*X*005010X210
ST*275*5001*005010X210
BGN*02*1000*20180514
NM1*PR*2*XYZ Insurance*****PI*21231
NM1*41*2*Demo Practice*****46*111134
NM1*1P*1*JOHN*MUFFY*M**M.D*XX*123456789
NX1*1P
N3*PO BOX 123*157 WEST 57TH STREET
N4*CINCINNATI*OH*43017
NM1*QC*1*CARROL*JENNIFER*T**PH.D*MI*9012345918341
REF*EJ*1231232
REF*EA*9999999
REF*D9*1212323
LX*1
TRN*1*123123
DTP*368*D8*20180514
CAT*AE*MB
EFI*05
BIN*1097*Mime-version: 1.0
Content-Type: application/pdf
Content-Transfer-Encoding: base64
Content-Disposition: attachment; filename=right_arm-pictures.pdf

JVBERi0xLjcKCjQgMCBvYmoKPDwKL0JpdHNQZXJDb21wb25lbnQgOAovQ29sb3JTcGFjZSAvRGV2aWNlUkdCCi9GaWx0ZXIgL0RDVERlY29kZQovSGVpZ2h0IDE3OAovTGVuZ3RoIDkzNDIKL1N1YnR5cGUgL0ltYWdlCi9UeXBlIC9YT2JqZWN0Ci9XaWR0aCA0ODkKPj4Kc3RyZWFtCv/Y/+AAEEpGSUYA
LX*2
TRN*1*52412
DTP*368*D8*20180514
CAT*AE*MB
EFI*05
BIN*2097*Mime-version: 1.0
Content-Type: application/pdf
Content-Transfer-Encoding: base64
Content-Disposition: attachment; filename=left_arm-pictures.pdf

JVBERi0xLjcKCjQgMCBvYmoKPDwKL0JpdHNQZXJDb21wb25lbnQgOAovQ29sb3JTcGFjZSAvRGV2aWNlUkdCCi9GaWx0ZXIgL0RDVERlY29kZQovSGVpZ2h0IDE3OAovTGVuZ3RoIDkzNDIKL1N1YnR5cGUgL0ltYWdlCi9UeXBlIC9YT2JqZWN0Ci9XaWR0aCA0ODkKPj4Kc3RyZWFtCv/Y/+AAEEpGSUYA
SE*25*5001
ST*275*5002*005010X210
BGN*02*2000*20180514
NM1*PR*2*XYZ Insurance*****PI*21231
NM1*41*2*Demo Practice*****46*111134
NM1*1P*1*Jake*Mike****XX*222226789
NX1*1P
N3*20 Cooper Square
N4*New York*NY*43017
NM1*QC*1*David*Steven*T**PH.D*MI*977777777341
REF*EJ*1222222
REF*EA*555555
REF*D9*9192192
LX*1
TRN*1*222123
DTP*368*D8*20180514
CAT*AE*MB
EFI*05
BIN*1097*Mime-version: 1.0
Content-Type: application/pdf
Content-Transfer-Encoding: base64
Content-Disposition: attachment; filename=pictures1.pdf

JVBERi0xLjcKCjQgMCBvYmoKPDwKL0JpdHNQZXJDb21wb25lbnQgOAovQ29sb3JTcGFjZSAvRGV2aWNlUkdCCi9GaWx0ZXIgL0RDVERlY29kZQovSGVpZ2h0IDE3OAovTGVuZ3RoIDkzNDIKL1N1YnR5cGUgL0ltYWdlCi9UeXBlIC9YT2JqZWN0Ci9XaWR0aCA0ODkKPj4Kc3RyZWFtCv/Y/+AAEEpGSUYA
LX*2
TRN*1*333123
DTP*368*D8*20180514
CAT*AE*MB
EFI*05
BIN*2097*Mime-version: 1.0
Content-Type: application/pdf
Content-Transfer-Encoding: base64
Content-Disposition: attachment; filename=pictures2.pdf

JVBERi0xLjcKCjQgMCBvYmoKPDwKL0JpdHNQZXJDb21wb25lbnQgOAovQ29sb3JTcGFjZSAvRGV2aWNlUkdCCi9GaWx0ZXIgL0RDVERlY29kZQovSGVpZ2h0IDE3OAovTGVuZ3RoIDkzNDIKL1N1YnR5cGUgL0ltYWdlCi9UeXBlIC9YT2JqZWN0Ci9XaWR0aCA0ODkKPj4Kc3RyZWFtCv/Y/+AAEEpGSUYA
SE*25*5002
GE*2*796
IEA*1*796000000

JSON to EDI 275 Message



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