Accredited ACH Professional (AAP) Practice Exam

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Which transaction set is utilized for payment captures in the healthcare sector?

ANSI ASC X12.835
ANSI ASC X12.813
ANSI ASC X12.823
ANSI ASC X12.820

The correct answer is: ANSI ASC X12.835

The ANSI ASC X12.835 transaction set is specifically designed for the healthcare sector to convey information regarding healthcare claims payment and remittance advice. This set includes detailed explanations related to payment adjustments, denials, and any other transactions associated with the payment process. In the context of payment captures, which involve the aggregation and reporting of payment amounts along with the relevant details needed to reconcile patient accounts, the X12.835 plays a critical role. It provides healthcare providers with vital information regarding the payments they receive from insurance companies or third-party payers. This ensures that healthcare organizations can accurately track and manage their revenue cycles, making it an essential tool for financial operations within the healthcare industry. The other transaction sets listed do not serve the same purpose in healthcare payment processing; they adhere to different aspects of the healthcare transactions. This distinction reinforces why the X12.835 is the correct answer for capturing payment information in healthcare.