Translator Attachment Adapter Overview

The Translator Attachment Adapter provides Healthcare Payers and Providers with the ability to create and extract 275 transactions with embedded attachments, as well as other useful tools.

Scenario for Use of the Adapter

The Translator Attachment Adapter is used by both Payer and Provider in the following scenario:
  1. The Payer receives a claim from a Provider pertaining to services rendered for an injury.
  2. The Payer decides that supporting information, specifically an x-ray of the injury, is needed before the claim can be processed.
  3. The Payer sends a request for additional information to the Provider.
  4. The Provider receives the request.
  5. The Translator Attachment Adapter is used by the provider to CREATE one of the following:
    • a 5010 275X210 Additional Information to Support a Health Care Claim or Encounter transaction with the requested attachment contained in the BIN02 segment
    • a 6020 275X316 Health Care Services Review transaction with the requested attachment contained in the BDS03 segment.
  6. The Provider sends the 275 transaction with the requested information back to the Payer.
  7. The Payer receives the 275 transaction containing the requested information.
  8. The Translator Attachment Adapter is used by the Payer to EXTRACT the requested attachment from the 5010 275X210 BIN02 or 6020 275X316 BDS03 segment.
Note: The Translator Attachment Adapter can be used for both unsolicited and solicited 275s.
  • An unsolicited 275 is one which a Provider creates and submits to a Payer without having been asked to do so.
  • A solicited 275 is one which a Payer has requested from a Provider, typically using a 277 Health Care Claim Request for Additional Information transaction.