NOTE - All new HIPAA EDI Transactions should be X12 5010 Version 

A lot of EDI providers make a huge deal of the security provisions of the HIPAA act, but please, don't worry about it. All HIPAA really says is that EDI transactions must be secure, and EDI Transactions have almost always been secure anyway. It's probably best to use FTPS, SFTP, HTTPS, or AS2 instead of just plain FTP though. FTP has never been that secure, but the other transmission protocols are secure, and easy to use. 

835: Health Care Claim Payment/Advice.

The 835 Health Care Payment / Advice, also known as the Electronic Remittance Advice (ERA), provides information for the payee regarding claims in their final status, including information about the payee, the payer, the payment amount, and any payment identifying information. An 835 is sent from insurers to the healthcare providers.

837: Health Care Claim.

To put it simply… the 835 is the receipt and the 837 is a bill. An 835 claim file is the format that insurance organizations send back to healthcare providers.



• 834: Benefit Enrollment and Maintenance.

• 820: Premium billing (Receipt).

• 278: Request for review and response.

• 270/271: Health Care Eligibility Benefit Inquiry and Response.

• 276/277: Health Care Claim Status Request and Response.

• 997: Functional Acknowledgement; TA1-Interchange Acknowledgement.

• 999: Acceptance/Rejection Advice.