Get the free EDI Information Form X12

This document is used to collect internal EDI information regarding trading partners, including transaction types currently in use and future plans.

How to fill out edi information form x12

How to fill out EDI Information Form X12

1. Obtain the EDI Information Form X12 from the relevant source.
2. Fill in the sender's details, including name, address, and contact information.
3. Provide the recipient's details in the designated section.
4. Specify the type of transaction being processed (e.g., purchase order, invoice, etc.).
5. Include the relevant identifiers such as DUNS number, NPI, or any other necessary codes.
6. Indicate the version of the X12 standard being used.
7. Review all the filled-in information for accuracy.
8. Submit the completed form to the appropriate authority for processing.

Who needs EDI Information Form X12?

1. Businesses that engage in electronic data interchange (EDI) transactions.
2. Suppliers that need to send invoices or purchase orders electronically.
3. Organizations that require standardized communication formats for data exchange.
4. Healthcare providers transmitting insurance claims or patient data.

People Also Ask about

What is the format of EDI document?

Standardized Format: EDI files use standardized formats like ANSI X12 (used in North America) or EDIFACT (used internationally), which define how data is organized and what each segment represents.

What is the X12 file structure?

X12 format structures include: Control structures, such as the control header and trailer, identify the beginning and end of a document, or interchange. These controls verify the integrity of the data contained in the transmission.

What is the difference between EDI and X12?

X12 is used primarily in North America, while EDIFACT is used globally. They both have their own unique features and benefits, such as X12's hierarchical structure and EDIFACT's flat structure. Both standards offer a wide range of message types, allowing organizations to exchange different types of data.

What is the X12 based on?

X12 is an ANSI-accredited, consensus-based, non-profit organization focusing on the development, implementation, and ongoing use of interoperable electronic data interchange standards.

What is the data type of X12?

All elements in X12 have a specific data type: elements can be a string (i.e., alphanumeric), number, decimal, date, time, code, or binary. These data types dictate the kind of data that can be sent in a specific element and how it should be treated by external systems ingesting the EDI.

What is the difference between hl7 and X12 EDI?

X12 EDI has more segment types, whereas HL7v2 ADT has more basic data types. However, HL7v2 is public. X12 EDI can be converted to FHIR. Just like HL7v2 ADT, messages, X12 messages contain healthcare data that may be converted into FHIR resources and bundles with a vendor like Tenasol.

What is X12 format in EDI?

X12 is a message formatting standard used for Electronic Data Interchange (EDI) documents. It's used by trading partners to share business documents in an agreed-upon and standard format. X12 is the most common EDI standard used in the United States.

What is X12 837 format?

The X12 837 and 835 files are industry standard files used for the electronic submission of healthcare claim and payment information. The 837 files contain claim information and are sent by healthcare providers (doctors, hospitals, etc) to payors (health insurance companies).

For pdfFiller’s FAQs

What is EDI Information Form X12?

EDI Information Form X12 is a standardized format used for electronic data interchange (EDI) to facilitate the exchange of business documents between organizations.

Who is required to file EDI Information Form X12?

Organizations that engage in electronic trading and need to exchange documents such as invoices, purchase orders, and other business data using the EDI X12 format are required to file the EDI Information Form X12.

How to fill out EDI Information Form X12?

To fill out EDI Information Form X12, organizations must provide detailed information about their EDI capabilities, including their transaction codes, contact information, and the types of documents they intend to exchange using the X12 format.

What is the purpose of EDI Information Form X12?

The purpose of EDI Information Form X12 is to ensure that organizations are equipped to communicate through electronic means efficiently and effectively while adhering to the X12 standards, thereby streamlining business operations.

What information must be reported on EDI Information Form X12?

The information that must be reported on EDI Information Form X12 includes the organization's name, EDI contact details, transaction set identifiers, specifications of the documents to be exchanged, and any relevant compliance information.