![]() ![]() One or more separate guides may be developed for life, flexible spending, and retirement products. ![]() This implementation guide specifically addresses the enrollment and maintenance of health care products only. This transaction set can be used to establish communication between the sponsor of the. The intent of this implementation guide is to meet the health care industry's specific need for the initial enrollment and subsequent maintenance of individuals who are enrolled in insurance products. This Draft Standard for Trial Use contains the format and establishes the data contents of the Benefit Enrollment and Maintenance Transaction Set (834) for use within the context of an Electronic Data Interchange (EDI) environment. The 834 is used to transfer enrollment information from the sponsor of the insurance coverage, benefits, or policy to a payer. The entire string is called a data segment. The Health Insurance Portability and Accountability Act (HIPAA) requires that all health plans or health insurance carriers accept a standard enrollment format: ANSI 834A Version 5010.Īn 834 file contains a string of data elements, with each representing a fact, such as a subscriber’s name, hire date, etc. The ANSI 834 EDI Enrollment Implementation Format is a standard file format in the United States for electronically exchanging health plan enrollment data between employers and health insurance carriers.
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June 2023
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