EDI 834 Benefit Enrollment and Maintenance Guide

An electronic document used to replace,
update, or cancel shipment along with creating new shipment.


Electronic Data Interchange (EDI) has spread its wings across multiple industries, making the exchange of information seamless and faster. It has replaced paper-based and manual transmission of data, thereby reducing errors and operational costs. The healthcare industry has also adopted EDI to reach its potential of administrative cost savings. For this purpose, EDI standards have been developed and implemented consistently by organizations. To ensure a smooth transition into the EDI environment, the sector must have a uniform implementation process. Hence, we have prepared this guide that provides standardized data requirements and content to users of Benefits Enrollment and Maintenance (834). The EDI 834 document is used to transfer enrollment information from the sponsor of the insurance coverage and benefits to a payer.

This implementation guide will take you through the healthcare sector’s specific needs for the initial enrollment and subsequent maintenance of individuals who are enrolled in different insurance policies. It also addresses enrollment and maintenance of healthcare products. So, let’s get started.


  • Overview of EDI 834 and Related Definitions
  • Data Architecture & Coverage Levels
  • Transaction Sets with Examples
  • Examples of EDI Transmission for Different Business Uses
  • ASC X12 Nomenclature
  • EDI Control Directory
  • Functional Acknowledgment Transaction Set
  • External Code Sources


  • The EDI 834 implementation guide will help you understand 834 standards and real-time transactions.
  • Get an overview of data architecture, coverage levels, and dependents.
  • The ebook provides multiple examples of EDI transmission and transaction sets for better understanding.
  • Learn about application control structure, business transaction structure, interchange & functional acknowledgment, and more.

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