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special enrollment period icon

Ask us about the new special enrollment period. You might be able to save. Call 855-330-2792.

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Questions about getting a COVID-19 vaccine? See the latest on our blog

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Professional claim

Transaction: 837P
Description: 005010X222A1
Status: In production

Institutional claim

Transaction: 837I
Description: 005010X223A2
Status: In production

 

Dental claim

Transaction: 837D
Description: 005010X220A1
Status: In production

 

Group enrollment

Transaction: 834
Description: 005010X220
Status: In production

Group enrollment - Exchange

Transaction: 834 - Exchange
Description: 005010X306
Status: In production

 

ERA (outbound)

Transaction: 835
Description: 005010X221
Status: In production

 

Healthcare eligibility inquiry
and response

Transaction: 270/271
Description: 005010X279
Status: In production

 

Healthcare claim status request
and response

Transaction: 276-277
Description: 005010X212
Status: In production

 

Healthcare claim request for additional information and response

Transaction: 277/275
Description: 005010X275
Status: In development

 

Healthcare services request
for review and response

Transaction: 278
Description: 005010X217
Status: In development

 

Group premium

Transaction: 820
Description: 005010X306
Status: In development

 

Need to enroll in our electronic payment system?

Download our Electronic Remittance Advice (835) and EFT Authorization form

For questions about electronic transactions, please contact edisupport@pacificsource.com