EDI 837 Professional Loops

EDI RESTful Web Service API

Are you looking for RESTful Web Service API to generate HIPAA X12 EDI Transactions? Then here is the solution offered. Please contact me for more details

Create an account in our Nagata EDI Tool and check  HIPAA X12 EDI Transactions sets.
Here is the demo link
https://demo.nagatabilling.com/NagataEDITool/login.zhtml 

1. JSON to EDI 270 Eligibility and Benefit Inquiry
2. Create EDI 270 from JSON
   
3. Parse EDI 271 Message to Human Readable Text
4. Parse EDI 277 Message to HTML
5. JSON to EDI 837 Professional Claims
6. Parse EDI 837p Message into JSON
7. Parse EDI 835 Message into JSON   
8. Parse EDI 835 Message to PDF
9. JSON to cms 1500 Form
10. Parse EDI 837p To HTML
11. JSON To EDI 837 Institutional
12. Parse EDI 837I to JSON
13. Parse EDI 837 Institutional To HTML
14. Create CMS 1500 Form using JSON
15. Parse EDI 837p to CMS 1500 Form
    
    
    

 

 

 

 

 

 

ASC X12 270: Eligibility, Coverage, or Benefit Inquiry.
This transaction allows providers to check whether a patient has insurance coverage as of a specified date. This transaction is typically sent by healthcare service providers, such as hospitals or medical facilities, and sent to insurance companies, government agencies like Medicare or Medicaid, or other organizations that would have information about a given policy. 

Minimum information such as Member Name, Date of birth and gender or subscriber ID is required to submit in the 270 message to get the response. If we are doing real time mode, then the expected response time will be  1 to 2 seconds.

Sample Workflow

1. Provider Smith uses ABC Billing Software aka Practice Management Software(PMS).
2. Provider Smith already signed up with XYZ Clearing House and an ID has been assigned to Provider Smith by the clearinghouse.
3. ABC Billing software has the option of generating EDI 270 messages and through web service call, it will send the message to the clearinghouse.
4. XYZ receives a message within a few seconds and then identifies the message for Payer Cigna. Since XYZ already enrolled with Payer Cigna, so it just forwards the message to Payer Cigna via web service.
5. Payer Cigna receives the message and prepares response 271 and sends it back to the clearinghouse. Immediately clearing house forward the response to the Provider Smith’s ABC billing software.
6. ABC Billing software parse the EDI 271 Message into Human-readable text and show it to the user.

 Download sample EDI 270
 Download Sample EDI 271
 Parse EDI 271 To HTML
 Parse EDI 271 To Text
 Parse EDI 271 To JSON