PNT provides comprehensive healthcare EDI services for organizations submitting and receiving standard ANSI X12 transactions in both batch and real-time. PNT supports the following real-time transactions:

 

Eligibility Verification and Response (270/271)

The ANSI X12N 270 transaction is used to request information from a Health Plan to determine a patient’s eligibility and benefits information. The ANSI X12N 271 transaction is the response to the eligibility request. The current standard version for these transactions is 5010.

PNT’s HIPAA compliant eligibility offering enables health insurance verification information to be exchanged in real-time or batch methods.

Information contained in this transaction includes:

  • Subscriber information
  • Services covered
  • Date of coverage
  • Co-pays
  • Deductible amount
  • Service benefits
  • Visit limits

 

Benefits of electronic health insurance eligibility:

  • Automated workflows
  • Decrease in rejected claims
  • Fewer collection costs
  • Increased cash flow
  • Increased patient transparency

 


Claims Status Inquiry (276/277)

The ANSI X12N 276 transaction is used to request information on the status of a claim already submitted to a Health Plan. The ANSI X12N 277 transaction is the response returned by the Health Plan. The current standard version for these transactions is 5010.

 

Benefits of electronic claim status inquiry:

  • Reduced manual workload
  • Greater staff efficiencies
  • Increased cash flow
  • Lower operational expenses

 


Prior Authorization (278)

The ANSI X12N 278 Health Care Services Review Information is used by healthcare providers to request authorization from Health Plans on various items.
PNT Data offers a real-time, HIPAA compliant 278 solution that supports the following prior authorization versions*:

  • 215 Request for Services
  • 216N Notification
  • 217 Status Inquiry

*version capability varies by payer (please see our payer transaction list)

 

Benefits of electronic prior authorization:

  • Reduced delays and errors
  • Improved administrative processing
  • Reduced manual workload
  • Reduced costs
  • Improved transaction quality

 

Why PNT Data?

  • High-touch support team
  • 99.99% uptime
  • 78 Net Promoter Score
  • User portal and other self-service tools
  • Hassle-free submitter onboarding
  • Submitter support and education
  • Industry-leading compliance, privacy, and security standards
  • We always pick up the phone!

Check our Payer ID List HERE and start submitting transactions today by filling out our online enrollment form HERE. Please contact us today for further information regarding enrollment at 860-257-2030 or at support@pntdata.com.