Billie,
If the Attachment NPRM ever got published, I believe it stipulates that if a provider sends an Attachment (a 275 transaction) with a claim (an 837 transaction), the Attachment transaction must be in the same Interchange (ISA-IEA) as the Claim transaction.  It would look something like:

ISA
    GS (for 837)
        ST (837)
        SE
    (theoretically you could have an unlimited number of additional 837 ST-SEs in this Functional Group)
    GE
    GS (for 275)
        ST (for 275, containing all attachments in the 837s in this Interchange)
        SE
    (theoretically you could have >1 275 ST-SE in this Functional Group)
    GE
    (theoretically you can have many GS-GE's within an Interchange)
IEA

This way, the payer can look for the attachment (they're linked between the 837 and the 275 with a trace number) in the interchange, just like they'd expect a paper attachment to arrive in the same envelope as the paper claim.  Of course The Attachment NPRM has not yet been published so who knows what it will actually say, but this is an example where there is a business benefit (in health care) to sending two types of transactions.  So far there hasn't been any compelling business reason to do this (as does exist in other industries).  As far as X12 goes, it's perfectly kosher to have more than one ST-SE within a Functional Froup (as long as all the transaction are the same type), and more than one Functional Group within in Interchange.

Jan Root
UHIN

"Adams, Billie Jo" wrote:

Is it possible to have more than one GS-GE per ISA-IEA?

Billie Jo Adams

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