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This document is designed for requests related to health care services reviews, including details about the utilization management organization, requester, subscriber, and related medical information.
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How to fill out 278_request

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How to fill out 278_Request

01
Obtain the 278_Request form from the appropriate source, such as your insurance provider or online.
02
Fill in the patient's demographic information, including name, date of birth, and insurance details.
03
Provide the requesting provider's information, including name, NPI number, and contact details.
04
Indicate the specific service or procedure being requested, along with any necessary medical codes.
05
Include clinical information that supports the request, such as diagnosis codes and relevant medical history.
06
Specify the dates of service if applicable, and any additional notes or requirements as needed.
07
Review the completed form for accuracy and completeness before submission.
08
Submit the form through the designated channels, whether electronically or via fax.

Who needs 278_Request?

01
Healthcare providers who need to obtain prior authorization for specific medical services or procedures for their patients.
02
Billing departments within healthcare facilities that need to ensure that services will be covered by insurance.
03
Patients who want to ensure that their planned procedures are pre-approved by their insurance companies.
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People Also Ask about

EDI Health Care Services Review (278) is used to request an authorization from a payer (an insurance company) by a healthcare provider, such as a hospital. It is to review the proposed healthcare services to be provided to a given patient, in order to obtain authorization for the services.
A healthcare provider, such as a hospital, will send a 278 transaction to request an authorization from a payer, such as an insurance company. The hospital is asking the insurance company to review proposed healthcare services to be provided to a given patient, in order to obtain an authorization for these services.
A healthcare provider, such as a hospital, will send a 278 transaction to request an authorization from a payer, such as an insurance company. The hospital is asking the insurance company to review proposed healthcare services to be provided to a given patient, in order to obtain an authorization for these services.
The X12 278 transaction contains information of whom is making the request, for which member, details of the entities performing the services, where and when the services are to be performed, the approval status and why the services are needed by inclusion of the diagnosis and other unique data to support the reason
The 278 AAA Segments are used to identify security validation requirement issues and to indicate BCBSNC business edits. Submitters that provide insufficient or invalid information within the 278 Review are sent a 278 Response with AAA segments identifying the error.

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The 278_Request is a form used to request prior authorization for certain healthcare services and procedures from insurance providers.
Healthcare providers and organizations seeking prior authorization for services are typically required to file the 278_Request.
The 278_Request should be filled out by providing the patient's information, the requested service details, diagnosis codes, and any relevant supporting documentation, ensuring it meets the insurer's specific requirements.
The purpose of the 278_Request is to facilitate communication between healthcare providers and insurance companies to ensure the necessary approvals for treatment before services are rendered.
The 278_Request must report patient demographics, service codes, diagnosis codes, provider details, and any supporting documentation needed for the authorization process.
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