As we prepare for the potential regulatory-proposed standards for electronic attachments, Anthem will be implementing X12 275 electronic attachment transactions (version 5010) for claims.

 

Standard electronic attachments will bring value to you by eliminating the need for mailing paper records and reducing processing time overall. 

 

Anthem and Availity will pilot electronic data interchange batch electronic attachments with previously selected providers. Both solicited and unsolicited attachments will be included in our pilots.

 

Attachment types

  • Solicited attachments: The provider sends a claim and the payer determines there is not enough information to process the claim. The payer will then send the provider a request for additional information (currently done via letter). The provider can then send the solicited attachment transaction, with the documentation requested, to process the claim.
  • Unsolicited attachment: When the provider knows that the payer requires additional information to process the claim, the provider will then send the X12 837 claim with the Paper Work Included segment tracking number. Then, the provider will send the X12 275 attachment transaction with the additional information and include the tracking number that was sent on the claim for matching.

 

What you can do

As we prepare for this change, you can help now by having conversations with your clearinghouse and/or electronic healthcare records vendor to determine their ability to set up the X12 275 attachment transaction capabilities.

 

In addition, you should be on the lookout for additional information and details about working with Anthem and Availity to send attachments via electronic batch.



Featured In:
October 2019 Anthem Blue Cross Provider News - California