EDI 274 Healthcare Provider Information

This X12 Transaction Set contains the format and establishes the data contents of the Abandoned Property Filings Transaction Set 274 for use within the context of an Electronic Data Interchange (EDI) environment. This transaction set is used to report abandoned property filings information, such as uncashed checks or abandoned bank account balances, to government agencies and may be used by the government agencies to distribute information on abandoned property for publication to the general public. It may also be used to initiate an Electronic Funds Transfer (EFT) payment to transfer the value of the abandoned property to the government agencies.

Segments

Position

Segment

Name

Max use

100

Transaction Set Header

Mandatory

AtMax 1

To indicate the start of a transaction set and to assign a control number

200

BHT

Beginning of Hierarchical Transaction

Mandatory

AtMax 1

To define the business hierarchical structure of the transaction set and identify the business application purpose and reference data, i.e., number, date, and time

300

DTM

Date/Time Reference

Opt

AtMax 1

To specify pertinent dates and times

400

PER

Administrative Communications Contact

Opt

AtMax 1

To identify a person or office to whom administrative communications should be directed

2000

LOOP

Mandatory

GT 1

100

Hierarchical Level

Mandatory

AtMax 1

To identify dependencies among and the content of hierarchically related groups of data segments

200

TRN

Trace

Opt

AtMax 1

To uniquely identify a transaction to an application

250

AAA

Request Validation

Opt

AtMax 1

To specify the validity of the request and indicate follow-up action authorized

2100

LOOP

Mandatory

GT 1

300

NM1

Individual or Organizational Name

Mandatory

AtMax 1

To supply the full name of an individual or organizational entity

400

Additional Name Information

Opt

GT 1

To specify additional names

500

PER

Administrative Communications Contact

Opt

GT 1

To identify a person or office to whom administrative communications should be directed

600

DMG

Demographic Information

Opt

AtMax 1

To supply demographic information

700

AMT

Monetary Amount Information

Opt

AtMax 20

To indicate the total monetary amount

800

API

Activity or Process Information

Opt

GT 1

To provide information on activity or process

900

DEG

Degree Record

Opt

AtMax 9

To provide information about an educational institution's academic award

1000

IND

Additional Individual Demographic Information

Opt

AtMax 1

To provide additional demographic information to the receiving school, institution, or agency to assist in identifying the particular student

1100

LUI

Language Use

Opt

AtMax 9

To specify language, type of usage, and proficiency or fluency

1200

DTP

Date or Time or Period

Opt

AtMax 9

To specify any or all of a date, a time, or a time period

1250

AAA

Request Validation

Opt

AtMax 1

To specify the validity of the request and indicate follow-up action authorized

1300

MTX

Text

Opt

GT 1

To specify textual data

1400

QTY

Quantity Information

Opt

AtMax 99

To specify quantity information

1500

Work Schedule

Opt

AtMax 99

To specify an individual's work schedule

1600

CRC

Conditions Indicator

Opt

AtMax 9

To supply information on conditions

1700

HSD

Health Care Services Delivery

Opt

AtMax 99

To specify the delivery pattern of health care services

1800

BCI

Basic Claim Information

Opt

AtMax 9

To identify information basic to the processing of any claims transaction

1900

PDI

Practice Detail Information

Opt

AtMax 1

To provide detail information on a health care provider's practice

2000

HAD

Hospital Affiliation Detail

Opt

AtMax 1

To provide detail information describing a provider's affiliation to a specific hospital

2110

LOOP

Mandatory

GT 1

2100

NX1

Property or Entity Identification

Opt

AtMax 1

To define the attributes of a property or an entity

2200

Additional Name Information

Opt

AtMax 1

To specify additional names

2300

Party Location

Opt

AtMax 2

To specify the location of the named party

2400

Geographic Location

Opt

AtMax 1

To specify the geographic place of the named party

2500

PER

Administrative Communications Contact

Opt

AtMax 1

To identify a person or office to whom administrative communications should be directed

2120

LOOP

Mandatory

GT 1

2600

Industry Code Identification

Opt

AtMax 1

To identify standard industry codes

2700

Party Identification

Opt

AtMax 2

To identify a party by type of organization, name, and code

2800

TPB

Business Professional Title

Opt

GT 1

To identify title of an individual within a company

2900

DTP

Date or Time or Period

Opt

AtMax 9

To specify any or all of a date, a time, or a time period

3000

QTY

Quantity Information

Opt

AtMax 1

To specify quantity information

3100

YNQ

Yes/No Question

Opt

GT 1

To identify and answer yes and no questions, including the date, time, and comments further qualifying the condition

3150

AAA

Request Validation

Opt

AtMax 1

To specify the validity of the request and indicate follow-up action authorized

2130

LOOP

Mandatory

AtMax 99

3200

HPL

Health Care Provider License

Opt

AtMax 1

To provide license, certification, accreditation, and registration information for health care providers

3300

DTP

Date or Time or Period

Opt

GT 1

To specify any or all of a date, a time, or a time period

3350

AAA

Request Validation

Opt

AtMax 1

To specify the validity of the request and indicate follow-up action authorized

2140

LOOP

Mandatory

GT 1

3400

REF

Reference Information

Opt

AtMax 1

To specify identifying information

3500

DTP

Date or Time or Period

Opt

AtMax 9

To specify any or all of a date, a time, or a time period

3550

AAA

Request Validation

Opt

AtMax 1

To specify the validity of the request and indicate follow-up action authorized

2150

LOOP

Mandatory

AtMax 9

3600

EMS

Employment Position

Opt

AtMax 1

To describe employment position

3700

DTP

Date or Time or Period

Opt

AtMax 9

To specify any or all of a date, a time, or a time period

3800

Transaction Set Trailer

Mandatory

AtMax 1

To indicate the end of the transaction set and provide the count of the transmitted segments (including the beginning (ST) and ending (SE) segments)

Elements

Position	Element	Name	Requirement	Type	Min/Max	Repeat

1	143	Transaction Set Identifier Code	Mandatory	ID	3/3	1

2	329	Transaction Set Control Number	Mandatory	Alphanumeric	4/9	1

3	1705	Implementation Convention Reference	Opt	Alphanumeric	1/35	1

EDI Dictionary

EDI 274 Healthcare Provider Information

Segments

Elements