An 834 document is a form used by employers to enroll their employees in a health insurance plan. An EDI 834 transaction allows employers to safely and securely enroll in their healthcare benefits. EDI 834 transactions are HIPAA compliant and meet the proper standards for the electronic data exchange of sensitive enrollment information.

 

When is an EDI 834 Form Used?

The 834 is used to transfer benefits enrollment information between an employer, union, or government agency to the appropriate insurance carrier. Specifically, an 834 must be used for new enrollees, making changes to enrollment, terminating enrollment, or reinstating benefits enrollment.

 

BeneQuick utilizes the X12 834 benefit enrollment transactions, as they are the industry standard for communicating benefits. Our system structure models the data elements in the 834 transactions. Having your benefits enrollment system match those data elements provides a seamless exchange of benefits enrollment data. Those who may be receiving the 834 forms include insurance carriers, healthcare organizations, and Medicare or Medicaid.

 

834 transactions help to eliminate a large pain in the benefits enrollment process; challenges during data import and export. It creates an industry standard for data mapping and ensures all information is input correctly and in the proper formats.

 

Despite these forms being ”industry standard,” there remain issues with the formatting between varying insurance providers. The same 834 transaction could be sent to three different carriers but they may all receive it differently. This is why it’s very important to find a benefits enrollment provider that can work with multiple insurance carriers and curate those forms to match their templates and formats to ensure a seamless data interchange.

 

Upon receipt, the insurance agency must respond with a 999 implementation acknowledgment. This means they’ve not only received the transaction on their end but accepted it. BeneQuick will never allow an X12 EDI 834 transaction to complete without that acknowledgment.

 

What Information is Included in an 834?

The typical 834 forms will include basic information like member name, address, and date of birth, plus the following:

  • Plan network ID
  • Subscriber Name
  • Subscriber ID
  • Benefits Information
  • Eligibility
  • Service ID

 

Finding an Industry Expert & Why it’s Important 

Finding a third-party administrator or other electronic data interchange entity can ensure your EDI 834 transactions remain seamless. It’s highly important to program the appropriate industry standard format while also conforming to the needs and formats of all different insurance carriers.

 

If the right demographic information does not go through the transaction set, it can negatively affect your plan membership and the integration of the information. Following EDI standards is critical to your member enrollment and maintaining solid implementation and processes.

 

BeneQuick provides an easy-to-use and user-friendly platform that allows brokers, TPAs, and employers to manage their highly unique needs. We can seamlessly import and export 834 data via excel, CSV, or any other format you use for your benefits enrollment. Our implementation is quick, ensuring you are able to get set up and prepared for your designated enrollment season.

 

Our expert team is dedicated to utilizing technology to the fullest all while keeping your data safe in our highly secure platform. We are here to help provide you and your team a tool to ensure a seamless enrollment process. Ready to get started? Request a FREE BeneQuick Demo here!

 

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