x12.org

Decode every X12 271 EB segment qualifier combination to determine the exact benefit coverage tier, network status, and cost-sharing amounts for a given service type code

Build the ISA, GS, ST, and SE envelope layers correctly and validate 999 and TA1 acknowledgment receipt before releasing a production X12 EDI batch

Construct an X12 820 premium payment transaction and reconcile it against payer enrollment records to ensure premium credits are posted correctly for each subscriber

Identify and populate every required loop and segment unique to an X12 837D dental claim that differs from an 837P professional claim

Implement loop 2320 coordination of benefits in an X12 837 claim to pass primary payer adjudication data when billing a secondary payer

Parse every PLB provider-level adjustment segment in an X12 835 remittance file and reconcile the adjustments against expected contract payments before posting to accounts receivable

Map every CLP, CAS, and SVC segment in an X12 835 to a structured payment object and detect partial payment patterns indicating a potential underpayment dispute

Construct a complete X12 276 claim status request targeting a specific claim control number and interpret every category and status code returned in the 277 response

Submit an X12 278 prior authorization request for a non-urgent outpatient procedure including all required clinical and diagnosis loops and handle a pend response with an additional documentation request

Implement the X12 835 CARC and RARC remark code lookup and build an automated denial routing workflow that maps each code pair to the correct denial management queue and next action

Build an X12 834 benefit enrollment transaction for a new hire group enrollment event and handle the subscriber and dependent demographic and coverage loops correctly

Construct an X12 837I institutional claim for an inpatient stay including all required UB-04 equivalent data elements in the correct loops and segments

Handle the X12 999 functional acknowledgment end-to-end by parsing AK2 and AK5 transaction set response loops and implementing automated error recovery without manual intervention for common rejection reasons

Transmit an X12 EDI 300 ocean freight booking request to a carrier and receive the EDI 301 booking confirmation response

Send an X12 EDI 304 shipping instructions transaction to an ocean carrier to provide cargo details and cut instructions for an active booking

Retrieve and parse an X12 EDI 310 ocean bill of lading transaction from a carrier's EDI endpoint

Subscribe to and parse X12 EDI 315 ocean shipment status messages from a carrier to track container events

Process an X12 EDI 322 terminal operations message for container gate-in and gate-out events at a marine terminal

Transmit an X12 EDI 309 customs manifest to a customs broker or CBP-connected system for cargo manifest filing

Understand the X12 278 health care services review request and response transaction structure

Identify and work with the key X12 278 loops and segments: UM, HI, and HCR

Submit an X12 835 Electronic Remittance Advice (ERA) to an accounts receivable system by parsing every loop, segment, and qualifier including PLB provider-level adjustments and CAS claim-level adjustment reason codes

Submit benefits enrollment data for new hires to a carrier using the ANSI X12 834 EDI transaction set via a clearinghouse

Submit X12 275 claims attachments under the CMS-0053-F final rule effective May 2026

Parse and map every benefit loop in an X12 271 eligibility response to a structured coverage object

Construct and transmit an X12 278 prior authorization request and handle synchronous approve, deny, and pend responses

Enroll for electronic ERA (835) and EFT delivery with a payer and validate the first live remittance file

Interpret CARC and RARC denial codes from an 835 ERA and route claims to the correct denial management queue

Attach clinical documentation to a claim using the X12 275 additional information transaction linked via PWK segment

X12 274 provider directory transaction handling

Build an X12 276 claim status inquiry and interpret every status category returned in the 277 response

Parse an X12 835 ERA file end-to-end including PLB provider-level adjustment segments and post payments to AR

Distinguish 999 functional acknowledgment, TA1 interchange acknowledgment, and 277CA claim acknowledgment and handle each in an EDI pipeline

Construct and submit an X12 278 prior authorization request and poll for the 278 response or pend notification

Attach clinical documentation to a claim using the X12 275 additional information transaction

Identify and apply the key segment differences between an X12 837P professional claim and an 837I institutional claim

Implement coordination of benefits (COB) in an X12 837 claim by populating Loop 2320 with primary payer adjudication data

Look up a payer ID, enroll a trading partner with a clearinghouse, and route 837 transactions to the correct destination

Interpret CARC and RARC remark codes from an 835 ERA denial and route claims to the correct denial management workflow

Choose between real-time claim adjudication and batch 837 submission and implement the appropriate flow for each use case

Build and submit a secondary claim with primary EOB data populated in the correct X12 837 loops for crossover billing

Complete EDI enrollment for ERA and EFT with a payer to enable electronic remittance delivery and direct deposit

Submit a claim void (frequency type 7) and a claim replacement (frequency type 8) to correct a previously submitted X12 837 claim

Determine timely filing limits by payer type and implement an appeal submission workflow for timely filing denial reversals

Submit an X12 278 prior authorization request to a clearinghouse

Submit an X12 837I institutional claim for a hospital inpatient stay

Build and submit an X12 834 benefit enrollment transaction

Parse an X12 999 functional acknowledgment to verify EDI submission acceptance