X12 835/277U Report Generator

Version 1.0

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 was signed into law by President Clinton on August 21, 1996. The administrative simplification subtitle of HIPAA established methods designed to improve the efficiency and effectiveness of the health care system by encouraging the development of health information systems that utilize electronic data interchange for certain administrative and financial transactions. Administrative simplification has enabled health care providers using custom software or HIPAA compatible business management systems the ability to automate both the billing of claims and the reconciliation of accounts.

HIPAA regulations require health care providers to transmit payment requests to insurance companies and/or government programs for services and supplies using one of three versions of the X12 837. The X12 837 transaction can be submitted directly by the provider or created and submitted by a billing agent or clearinghouse based on health care information sent to the provider's agent in non-X12 format. Processed claims are returned to the provider as an X12 835 transaction if payment is paid or denied or as an unsolicited X12 277U if pended (awaiting additional information or action).

Florida Medicaid providers presently have a choice of receiving remittance advice in a paper format, as an electronic remittance voucher (ERV - an image of the printed report), or as X12 electronic transactions. The ERVs will be available during the contingency period, but will be discontinued at the end of this transition period. The 835/277 Report Writer is designed for those providers who wish to receive electronic transactions, but don't yet have the capability of automating the processing of these transactions.

The 835/277 Report Writer is not restricted to Florida Medicaid files. It may be used to read and print any 835 or 277U transaction.

Download Intructions: Click the "Version 1.0" link below. Click the "Open" button. Click the "Unzip" button. Click "OK" when the "WinZip Self-Extractor" window appears.

The "Getting Started" PDF document contains instructions for setting up and using the report writer. The document will be download to the AHCA_Temp folder during the Version 1.0 download process. Navigate to the AHCA_Temp folder by double clicking "My Computer" on the desktop. Double click the "Local Disk (C:)" icon. Open the AHCA_Temp folder by double clicking the folder icon. Double click the "Getting Started Document.doc" icon. The "Getting Started Documentation" can be printed or read on your computer screen.

Comments about the tool/user documentation or reports of defects can be sent to X12 Tools Administrator. THE STATE OF FLORIDA WILL NOT PROVIDE TELEPHONE OR E-MAIL SUPPORT FOR THIS TOOL!

Download Intructions: Click the "Version 1.0 Download" link below. Click the "Open" button. Click the "Unzip" button. Click "OK" when the "WinZip Self-Extractor" window appears.

Version 1.0 Download

DISCLAIMER: The State of Florida (including its employees and agents) assumes no responsibility for consequences resulting from the use of the information herein, or in any respect for the content of such information including (but not limited to) error or omissions or the accuracy or reasonableness of assumptions made in the design of the X12 835/277U Report Generator. The State of Florida is not responsible for, and expressly disclaims all liability for, damages of any kind arising out of use, reference to, or reliance on such information obtained from the X12 835/277U Report Generator and makes no guarantees or warranties, including (but not limited to) any expressed or implied warranties of fitness for a particular use or purpose with respect to the use of the tool.