ASC X12N Version 7030™ Public Comment Period


Medical and health insurance claim form with stethoscope on clipboard

The American Standards Committee X12’s Insurance Subcommittee (ASC X12N) has released a revised schedule of public comment and review periods for version 7030™ of the Type 3 Technical Reports (TR3’s. Originally scheduled to begin April 1, 2016, the review and comment period will consist of eight (8) staggered cycles beginning September 1, 2016 and ending June 30, 2017. Each cycle will last sixty (60) days, with the exception of the comment period for 837 health care claims transactions, which is scheduled to last ninety (90) days.

ASC X12N Version 7030™ will replace Version 5010™ which went into effect January 1, 2012. The estimated publication date for Version 7030™ is September, 2017. ASC X12N, along with The National Council for Prescription Drug Programs Telecommunication, Version D.0 (NCPDP D.0), are the recognized standards for electronically transmitting the following health care claims in accordance with the Health Insurance Portability and Accountability Act (HIPAA).

TransactionStandard
Eligibility for a health plan (request and response)—Dental, Professional and InstitutionalASC X12N 270/271
Eligibility for a health plan (request and response)—Retail pharmacy drugsNCPDP D.0
Enrollment and disenrollment in a health planASC X12N 834
Referral certification and authorization (request and response)—Dental, Professional and InstitutionalASC X12N 278
Referral certification and authorization (request and response)—Retail pharmacy drugsNCPDP D.0
Health care claims or equivalent encounter information—DentalASC X12N 837D
Health care claims or equivalent encounter information—ProfessionalASC X12N 837P
Health care claims or equivalent encounter information—InstitutionalASC X12N 837I
Health care claims or equivalent encounter information—Retail pharmacyNCPDP D.0
Health care claims or equivalent encounter information—Retail pharmacy supplies and professional servicesASC X12N 837P and NCPDP D.0
Health care claim status (request and response)ASC X12N 276/277
Coordination of Benefits – Retail pharmacy drugsNCPDP D.0
Coordination of Benefits – DentalASC X12N 837D
Coordination of Benefits – ProfessionalASC X12N 837P
Coordination of Benefits – InstitutionalASC X12N 837I
Health care payment and remittance adviceASC X12N 835
Health care payment and remittance advice (RA)ASC X12N 835 TRN Segment