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Standard Companion Guide Refers to the Implementation Guide Based on X12 Version 005010×217 Request for Review and Response (278) Companion Guide Version Number 9.0 September 28, 2018Page 1 of 48CHANGE

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How to fill out asc x12n 278

01

To fill out ASC X12N 278 form, follow these steps:

02

Start by providing the general information at the top of the form, including the name of the requesting organization and the contact information.

03

Next, enter the patient information, including their name, date of birth, gender, and insurance details.

04

Specify the service type by choosing one of the options provided, such as admission, discharge, or transfer.

05

Fill out the medical provider information, including their name, address, and contact details.

06

Provide the details of the service being requested, including the date and time, the procedure codes, and any related diagnoses.

07

If there are any additional requirements or special instructions, make sure to include them in the designated section.

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Finally, review the completed form for accuracy and ensure all necessary attachments are included before submitting it.

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It is important to double-check the form for accuracy and completeness to avoid any delays or rejections.

Who needs asc x12n 278?

01

ASC X12N 278 is needed by healthcare providers, such as hospitals, clinics, and medical practices, who want to request authorization for healthcare services. It is commonly used for requesting prior authorization for medical procedures, surgeries, hospital admissions, and other healthcare services that may require approval from insurance providers or oversight entities. This form helps streamline the authorization process and ensures that the requesting organization provides all necessary information to obtain the necessary approvals. Additionally, this form is also used by insurance companies to receive and process authorization requests.

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What is asc x12n 278?

ASC X12N 278 is a standard electronic transaction format used for the submission of healthcare prior authorization requests.

Who is required to file asc x12n 278?

Healthcare providers, facilities, and insurance companies are required to file ASC X12N 278.

How to fill out asc x12n 278?

ASC X12N 278 must be filled out with all relevant patient and healthcare provider information, along with details of the requested healthcare service.

What is the purpose of asc x12n 278?

The purpose of ASC X12N 278 is to streamline the prior authorization process in the healthcare industry, reducing paperwork and improving efficiency.

What information must be reported on asc x12n 278?

ASC X12N 278 requires reporting of patient demographics, healthcare provider information, service details, and authorization requests.

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