Anthem Blue Cross and Blue Shield (Anthem) and Availity Electronic Data Interchange (EDI) is 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 to submit an authorization and referral requests electronically.


A prior authorization issued by Anthem provides you the go-ahead to perform the necessary service and a referral used to refer a member to a specialty provider. 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 transaction?


Both transactions offer:

  • 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.



Featured In:
August 2020 Anthem Provider News - Missouri