Alaska Medicaid HIPAA EDI Requirements And Transactions Guidelines

Alaska Medicaid HIPAA EDI Companion Guide is authored by the health plan. The purpose of a companion guide is to supplement the Technical Reports Type 3 (TR3s) which are also known as the HIPAA EDI Implementation Guides. These TR3s can be purchased at the X12 Store. Companion guides are available for download from the health plan’s website.

To learn more about HIPAA EDI, TR3s and become a certified EDI professional please visit our course schedule page.

Like most states, the state of Alaska has a Medicaid program. According to, Alaska has over 215,000 members in Medicaid and CHIP programs.

Most states use a private health plan to administer insurance. These are known as MCO (Managed-Care-Organizations). For example, United Healthcare is one of the MCOs for states such as Arizona and Maryland. CareSource is the MCO for the state of Ohio and Georgia. There are hundreds of such health plans serving 48 states.

Alaska and Wyoming are an exception. They do not use an MCO.

Medicaid Agencies use Electronic Data Interchange (EDI) technology for these transactions. Alaska is one of the Medicaid agencies using EDI. Alaska has contracted with Conduent EDI Solutions, Inc. to process EDI Transactions.

Alaska uses standard HIPAA EDI Transactions which are listed below.

Alaska Medicaid does a good job explaining the EDI Acknowledgement process. The below flow charts show the EDI Editing and Validation Flow Diagram.

Alaska Medicaid HIPAA EDI

The validation and acknowledgement processing diagram below shows the inbound processing workflow for the inbound 837 professional claim. We strongly encourage you view the Alaska Medicaid Companion guides which contain links in the paragraph above.

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