Coming soon: Enhance your prior authorization and inpatient admission and discharge notification via electronic and digital self-service for 2020

Anthem Blue Cross (Anthem) and Availity Electronic Data Interchange (EDI) are excited to announce the Prior Authorization/Referrals 278 and Inpatient Admission and Discharge Notification 278N 5010 transactions functionality is coming soon.

Prior Authorization and Referral Request (278)

The EDI 278 transaction supports healthcare providers when they submit authorization and referral requests electronically.

A prior authorization issued by Anthem provides you the go-ahead to perform a necessary service or refer a member to a specialty provider. You can transmit this transaction in real-time or batch mode. You will receive confirmation numbers to validate receipt of request.

Inpatient Admission and Discharge Notification 278N

 

Use the Hospital Admission Notification (278N) transaction to exchange admission notification data between an inpatient facility and Anthem in a standard format.

Similar to the HIPAA 278 transaction that you may already use to submit authorizations or referrals, the EDI 278N is the simplest, most efficient way to communicate facility admissions. You can also transmit through Availity in either batch or real-time format.

What are the benefits of 278 and 278N transactions?

• Simplify administrative tasks and increase productivity.
• Reduce administrative costs through automation and fewer phone calls, faxes or keying.
• Increase data accuracy by reducing manual errors.

 

Specifically for 278N, hospitals that have implemented EDI 278N:

• Experience an improvement in notification submissions within 24 hours.
• Can confirm a notification of admission is on file in the form of a service reference number generated upon registration.
• Submit notification of discharge.

How to send a 278 and 278N Transaction

Look for more communications coming soon around how to work with your practice management software vendor or billing/service clearinghouse or view a companion guide to send a 278 or 278N transaction.

588-0820-PN-CA