The U.S. HIPAA EDI Benefit Enrollment and Maintenance Set (834) is a standard defining the requirements for electronic data transfer between employers, unions, agencies or associations and healthcare organizations that pay claims or administer insurance. The healthcare organizations are known as payers. The Set covers member enrollment information such as benefits, subscription details, and demographics, and is typically used for health plan enrollment, changes, and termination of membership.
Sage People provides a generic HIPAA 834 file configuration for Payflow™, enabling you to build a data feed for a healthcare insurance provider that conforms to the 834 standard. The 834 standard comprises a number of mandatory fields but also allows flexibility in implementation, in part to enable conformity with the requirements of individual States.
The generic configuration is intended to ease and accelerate building 834 compliant feeds, but it is not usable without further configuration - there is no single definition of the complete 834 standard that can be implemented without some modification. For each feed you need to:
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Read the payer's (carrier's) implementation notes for their variant of the 834 standard.
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Build the data mapping to conform to the details of the implementation.
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Amend the Header and Footer content to match the requirements of the payer
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Build and test the link to the payer.