Table 2: ASC X12N Attachments Activity Table Attachment Activity Basis Actor Envelope/ Healthcare Example Activity Transaction Administrative Originator Activity Type Figure ID Standard Solicited Unsolicited Originator Receiver Activity ID Example #1 Request X Payer Provider ASC X12N 277 Claims #2 Response X Provider Payer ASC X12N 275 Attachment #3 Attachment Submission X Provider Payer ASC X12N 275 #4 Request X Payer Provider ASC X12N 278 Prior Auth #5 Response X Provider Payer ASC X12N 275 Attachment #6 Attachment Submission X Provider Payer ASC X12N 275 Payer/ Referred To #7 Request X ASC X12N 278 Referring Provider Provider Referral Referred To Payer/ #8 Response X ASC X12N 275 Attachment Provider Referring Provider Referred To Payer/ #9 Attachment Submission X ASC X12N 275 Provider Referring Provider Notification Primary care #10 Attachment Submission X Facility provider ASC X12N 275 Attachment provider Post #11 Request X Payer Provider ASC X12N 277 Adjudicated Claim #12 Response X Provider Payer ASC X12N 275 Attachment *References to the Envelope Transaction Standards are generic in this table. Implementers should use the version of the Technical Report published for the purposes of exchanging Attachments based on their business requirements or regulatory mandate.
Table 2: ASC X12N Attachments Activity Table Healthcare Administrative Activity Activity ID Originator Activity Type Attachment Activity Basis Actor Example Figure ID Envelope/ Transaction Standard Example Solicited Unsolicited Originator Receiver Claims Attachment #1 Request X Payer Provider ASC X12N 277 #2 Response X Provider Payer ASC X12N 275 #3 Attachment Submission X Provider Payer ASC X12N 275 Prior Auth Attachment #4 Request X Payer Provider ASC X12N 278 #5 Response X Provider Payer ASC X12N 275 #6 Attachment Submission X Provider Payer ASC X12N 275 Referral Attachment #7 Request X Payer/ Referring Provider Referred To Provider ASC X12N 278 #8 Response X Referred To Provider Payer/ Referring Provider ASC X12N 275 #9 Attachment Submission X Referred To Provider Payer/ Referring Provider ASC X12N 275 Notification Attachment #10 Attachment Submission X Facility provider Primary care provider ASC X12N 275 Post Adjudicated Claim Attachment #11 Request X Payer Provider ASC X12N 277 #12 Response X Provider Payer ASC X12N 275 *References to the Envelope Transaction Standards are generic in this table. Implementers should use the version of the Technical Report published for the purposes of exchanging Attachments based on their business requirements or regulatory mandate.