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If you have or plan to implementthe HIPAA-adopted X12 835 transaction for electronic remittances, we need your help.  The survey included in this document is to assist WEDI and the Designated Standard Maintenance Organizations (DSMO) in providing an accurate cost-benefit analysis to the federal government for adopting a newer version of the X12 835 under HIPAA – version 4050.  This survey must be completed by Wednesday, August 10, 2005.


Since the 4010 version of the 835 was adopted under HIPAA in October 2000, the X12 standards development organization has made significant improvements.  As with any standard, industry needs change, adjustments are necessary, and improvements are made.  To keep pace with technology, advances in healthcare and for the industry to benefit from these changes, Health and Human Services must adopt a new version under HIPAA.

The 4010 Transaction standards were developed in 1998, and the implementation guides that were initially adopted for HIPAA were written in 2000.  When the industry began to implement the HIPAA transactions, numerous problems were identified in the implementation guides; some serious enough that successful implementation would not have occurred.  These problems were corrected by the addenda to 4010, now called 4010A1, which were adopted in March 2003 for HIPAA implementation.  In the time since version 4010 was developed, X12 has made numerous changes to the original transaction standards in response to industry needs in versions 4020, 4030, 4040, and 4050.  At this point, the 4010 transactions standards are almost 7 years old and the implementation guides are 5 years old; numerous changes have occurred since these were first issued that have not yet been made available to the industry via adoption under HIPAA.

X12 has created a new Implementation Guide (IG) for version 4050 of the 835 transaction, which is inclusive of all changes since 4010A1.  This IG addresses a number of issues and problems that were identified by the industry.  There are only minor structural changes in version 4050, but in terms of additional code values, clarifications, and implementation specifications, much has been done to improve the quality and usefulness of this transaction.

Attached is a document that describes the Cost/Benefits that X12 believes can be realized from implementation of this new version of the 835 transaction with its associated IG.  Please read this prior to completing the survey, as it will help you to better understand the changes that are contained in this version from the current adopted version 4010A1.

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As you can see, many key issues have been clarified and numerous ambiguities were addressed and resolved.  We believe that this will have a positive industry impact, and that the implementation specifications will greatly improve the capabilities of the transactions and help the industry to realize some of the much-needed ROI that can be obtained from this transaction when implemented.

X12 has recommended to the DSMO that the 835 version 4050 and its IG be adopted as a HIPAA transaction.  The DSMO is composed of the following organizations: NUBC, NUCC, DeCC, HL7, NCPDP, and X12.  Each of these organizations reviewed these changes and agreed that qualitatively they represent a significant improvement to the standard, and that this version change should be recommended.

When reviewing this recommendation with the National Committee on Vital and Health Statistics (NCVHS), NCVHS indicated that before they could take a recommendation to the Secretary for adoption, a Cost/Benefit analysis must be provided.  X12 went back to review the request and concluded that more direct industry input was needed.

In response, the DSMO has asked WEDI to assist in evaluating the Cost/Benefits of implementing this standard.  WEDI has agreed to help, and has developed this survey as a start.  The analysis from this survey will be included in the DSMO’s final recommendation to NCVHS and incorporated in the Proposed Rule.

It is also realized that version 5010 changes will soon be completed by X12 and that these will eventually be brought forward.  While 5010 may be a little better for the 835 transaction than the 4050 version, we believe that the changes that are available now in version 4050 will make significant improvements to the industry and that we should not wait.  However, even if 5010 were adopted in favor of 4050, we believe this survey will still be useful, as the changes between 4050 and 5010 in terms of Cost/Benefits would be minimal.  So, if you are feeling that 5010 should be adopted versus 4050, we would still strongly encourage you to participate in this survey, as we believe the information you provide will be most relevant and critical to our process.

We hope that you will take this opportunity to provide your input on the Cost/Benefits for implementing the 4050 version of the X12 835 transaction by responding to this survey located at  It is extremely important for the industry to have a voice in this process, and this is your chance to be heard.