Eligibility & Benefits Standards and Operating Rules
The Health Care Eligibility Benefit Inquiry and Response and the associated X12 Technical Report Type 3 Implementation Guides provide the HIPAA-adopted standards for healthcare eligibility and benefit inquiries. These guides provide standardized data content for creation and use of the v5010 270/271 transaction. The 270 transaction set is used throughout the healthcare marketplace to transmit healthcare eligibility and benefit inquiries from health care providers, insurers, clearinghouses and other healthcare adjudication processors.