ASC X12 - TR3 Change Request

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TR3 Revision Requests

Requests for revisions to the ASC X12 Technical Reports mandated under HIPAA may be submitted via the Designated Standard Maintenance Organizations website, www.hipaa-dsmo.org.

Requests for revisions to other ASC X12 Type 3 Technical Reports (TR3s) may be submitted using the form below.

The deadline for change requests for the 006020 implementation guides has passed. Additional requests will be considered for inclusion in a future version.

The ASC X12 Insurance Subcommittee has implemented a new process for managing change requests, beginning with this ASC X12 006020 maintenance cycle. The new process shortens the timeline for revisions to ASC X12 TR3s by as much as 15 months, to approximately 21 months.

"ASC X12 is committed to timely development, approval and publication of updated work products that meet the changing needs of the industries we support," said Cathy Sheppard, ASC X12 Chair. "We look forward to evaluating the needs presented for inclusion in our next version."

Enter a Change Request

 
 
 

Check the box for one or more TR3. Enter enough information to identify a location in the document, use section and page numbers, loop IDs, and reference designators. For example, for the front matter: "Section 1.4, page 3, third paragraph" for a data element: "Loop 2000A, page 75, NM105". Click submit at the bottom of the form.

005010X187 269
  Health Care Benefit Coordination Verification Request and Response
 
005010X279 270/271
  Health Care Eligibility/Benefit Inquiry and Information Response
 
005010X210 275
  Additional Information to Support a Health Care Claim or Encounter
 
005010X211 275
  Additional Information to Support a Health Care Services Review
 
005010X212 276/277
  Health Care Claim Status Request and Response
 
005010X213 277
  Health Care Claim Request for Additional Information
 
005010X214 277
  Health Care Claim Acknowledgment
 
005010X228 277
  Health Care Claim Pending Status Information
 
005010X215 278
  Health Care Services Review Inquiry/Response
 
005010X216 278
  Health Care Services Review - Notification
 
005010X217 278
  Health Care Services Request for Review and Response
 
005010X218 820
  Payroll Deducted and Other Group Premium Payment for Insurance Products
 
005010X186 824
  Application Reporting for Insurance
 
005010X220 834
  Benefit Enrollment and Maintenance
 
005010X221 835
  Health Care Claim Payment/Advice
 
005010X222 837
  Health Care Claim: Professional
 
005010X223 837
  Health Care Claim: Institutional
 
005010X224 837
  Health Care Claim: Dental
 
005010X225 837
  Health Care Service: Data Reporting
 
005010X291 837
  Health Care Predetermination: Professional
 
005010X292 837
  Health Care Predetermination: Institutional
 
005010X230 997
  Functional Acknowledgment for Health Care Insurance
 
005010X231 999
  Implementation Acknowledgment for Health Care Insurance
 

For additional information:
e-mail chair@x12.org