EDI Mapping Guides For WPS Health Solutions: Control Segments / Envelopes EDI Mapping Guides require that Interchange Control (ISA/IEA), Function Group (GS/GE), and Transaction (ST/SE) envelopes must be used as described in the national implementation guides. Medicare’s expectations for inbound ISAs and a description of data on outbound ISAs are detailed in this EDI Mapping Guides post. Read More →

  Town Shoes Vendor Portal Requirements Town Shoes Vendor Portal data exchange testing is done by vendor in a “self-service” environment using the SPICE Connect Compliance Portal for Town Shoes. Town Shoes Vendor Portal compliancy testing is web based. Catalogues have two master options for loading. These options are set on the web portal. Append – new items Read More →

270/271 Eligibility and Benefit Inquiry and Response Transaction Guidelines 270/271 Eligibility and Benefit Inquiry and Response guidelines describe recommendations for HMSA partners involved in electronic documents transmission. The main requirements include the following: If multiple payers or multiple HMSA contracts cover a patient, the 271 response will contain multiple EB segments (where EB01 = “R” Read More →

832 Price/Sales Catalog Mapping Guidelines (Town Shoes EDI Program) 832 Price/Sales Catalog users (EDI Trading Partners) may experience difficulties in generating and transmitting an EDI 832 Price/Sales Catalog file. If this is the case with you, please utilize Town Shoes web-based NPLS application to upload your catalogue. The following LIN segment fields are mandatory but please see Read More →

832 Price/Sales Catalog Mapping Notes (Town Shoes EDI Program) 832 Price/Sales Catalog Mapping user notes will help all Town Shoes EDI vendors to create EDI maps according to the set requirements (X12/V4010/832). EDI General Information: VAN: HP MFT AS2: Available FTP: Preferred Portal: https://www.connectspice.com/portal/ ISA Qualifier: ZZ ISA ID: TOWNSHOESLTD GS ID: TOWNSHOESLTD ISA Test / Read More →

Matching 27x Request and Responses In Electronic Data Interchange Between HMSA And Its Partners Matching 27x Request and Responses recommendations are given to facilitate electronic documents transmission. The matching of a 27x request transaction with its response, it is recommended that a unique trace number be submitted in TRN02 at the patient level (Subscriber or Dependent loop) and, Read More →

Identifying GTIN In Outbound EDI 5010 maps Identifying GTIN in Kroger EDI outbound 5010 maps (for transactions 810, 812, 830, 832, 850, 867, 875, 880) vendors have the possibility of case items being sent as UPCs (UA qualifier) or GTINs (UK qualifier). The MFG id (which is made up of the package level indicator, the Read More →

997 Functional Acknowledgement And Claim Audit Report For BCHP Vendors 997 Functional Acknowledgement is returned for each batch transaction received. This file acknowledges the receipt of the file and reports any data compliance issues. BUCKEYE COMMUNITY HEALTH PLAN also expects to receive a 997 Functional Acknowledgement transaction when the trading partner receives any outbound batch transaction. Read More →