WI · guidance
Wis. ForwardHealth Online Handbook, Hospice, Topic #462
Electronic Transactions
HIPAA (Health Insurance Portability and Accountability Act of 1996) ASC (Accredited Standards Committee) X12 Version
5010 Companion Guides and the NCPDP (National Council for Prescription Drug Programs) Version D.0 Payer Sheet are
available for download on the HIPAA Version 5010 Companion Guides and NCPDP Version D.0 Payer Sheet page of the
ForwardHealth Portal.
Trading partners may submit claims and adjustment requests, inquire about member enrollment, claim status, and ForwardHealth
payment advice by exchanging electronic transactions.
Through the EDI (Electronic Data Interchange) Helpdesk, trading partners may exchange the following electronic transactions:
• 270/271 (270/271 Eligibility & Benefit Inquiry and Response): The 270 is the electronic transaction for inquiring about a
member's enrollment. The 271 is received in response to the inquiry.
• 276/277 (276/277 Health Care Claim Status Request and Response): The 276 is the electronic transaction for checking
claim status. The 277 is received in response.
• 278 (278 Health Care Services Review — Request for Review and Response): The electronic transaction for health care
service PA (prior authorization) requests.
• 835 (835 Health Care Claim Payment/Advice): The electronic transaction for receiving remittance information.
• 837 (837 Health Care Claim): The electronic transaction for submitting claims and adjustment requests.
• 999 (999 Acknowledgment for Health Care Insurance): The electronic transaction for reporting whether a transaction is
accepted or rejected.
• TA1 interChange Acknowledgment: The electronic transaction for reporting a transaction that is rejected for interChange-
level errors.
• NCPDP D.0 Telecommunication Standard for Retail Pharmacy claims: The real-time POS (Point-of-Sale) electronic
transaction for submitting pharmacy claims.
Provenance
- Source
- www.forwardhealth.wi.gov
- Retrieved
- 2026-10-02
- Edition
- forwardhealth-hospice-2026-10-01
- Content hash
777db0b8317920b15cea4caee750afa97127c5ac29a7c37368b4801d1c08bd90
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