Standards & EDI
X12 275
Draft — pending verification
This reference entry has not yet been verified against its authoritative source (Original definitions; regulatory facts to be verified against CMS-0057-F (89 FR 8758) and X12/HL7 documentation). Do not rely on it for production configuration until this notice is removed.
In more depth
In prior-auth workflows the 275 (or portal upload, fax, or FHIR-based documentation via DTR/PAS) is how the clinical evidence gets to the reviewer. Because attachments were never universally mandated the way core transactions were, capabilities vary widely across payers and clearinghouses.