United Healthcare Medicare

277CA Rejection – United Healthcare Medicare Advantage plans Federal and state guidelines require that United Healthcare work with health care professionals to help ensure practice data and demographic information is up-to-date and accurate for claims processing. UnitedHealthcare applies edits when an electronically submitted claim is either missing key health care professional information or does not match internal Read More →

277CA edits

277CA edits for Medicare Advantage plans: United Healthcare quick reference guide UnitedHealthcare applies edits when an electronically submitted claim is either missing key health care professional information or does not match internal systems. These claims will be returned electronically on a 277CA (claims acknowledgement) clearinghouse rejection report with instructions on what to correct and subsequently resubmit Read More →

EDI Claim Rejection

United Healthcare Rejection Messages Guides A sending party must ensure correct claim procedure. Learn about Claim Rejection Messages and definitions below. Individual health care professional claims E001 – E001 Rejected Claim. Missing rendering provider name. Resubmit with FULL provider name loop 2310B. Confirm CORRECT REMITTANCE ADDRESS. Include taxonomy code as applicable. Refer to UHCprovider.com/edicontacts for additional information Read More →

EDI Mapping

EDI Mapping Notes: Learn Useful Tips The content of the data and the format of the data have to make sense to the mapper.  If the mapper feels that the input or the output format of the data is unreasonable (e.g. too much unnecessary data) then the mapper should make the case for this concern and Read More →

Carton Label Samples

Carton Label Samples (EDI Order Consolidation) In the previous posts we have learned about several practical cases as for EDI Order Consolidation by the Brand Owner and by the Retailer. Below are given Carton Label examples sample formats of GS1-128 labels that may be used for communicating the consolidated shipment. Each company should define the format with its Read More →

EDI Order Consolidation

EDI Order Consolidation by the Retailer (Use Case) A retailer creates a purchase order that consolidates several products that would normally be transmitted on separate purchase orders. The resulting purchase order sent to the brand owner may contain products from different department numbers, class numbers, or other divisions within the retailer’s and brand owner’s systems. The Read More →

Order Consolidation Mapping

EDI Order Consolidation Mapping Guides In the previous post, we have described a practical scenario of an EDI Order Consolidation given by GS1. Find below some mapping guidelines. 1 ST*856*0001 2 BSN*00*GlobalShpmentIdNo*21080819*2120*0003 3 HL*1**S 4 TD1**1****G*20.00*LB 5 TD5**2*UPSN*U*UPS*CC 6 REF*BM*BOLIdNo 7 MAN*SM*ShpmentIdNo 8 DTM*011*20181114*2120 9 N1*BY*CompanyName*UL*GobalLocationNumber 10 N2*AltName1*AltName2 11 N3*Addess1*Address2 12 N4*CityName*ST*C*C****Postal-Code 13 N1*BY*CompanyName*UL*GobalLocationNumber 14 Read More →

EDI Transmits

EDI Transmits Tips (Lord & Taylor Vendor Transmissions) If vendor errors are identified during EDI Transmit, expense offset charges may be assessed. Vendors should note that if changing VANS from Lord & Taylor direct connect mailboxes at GXS and Inovis Inc., to any interconnect, all 852 Sales Data Reports will be turned off. Assign a Read More →

Florida Health X12 834

Florida Health Care Plan X12 834 Transaction FHCP processes the ASC X12 834 transaction for Benefit Enrollment and Maintenance. These 834 brief mapping guidelines help FHCP trading partners to supplement the 834 TR3. It briefly describes the global data content, business rules, and characteristics of the 834 transaction. All Segments. Only loops, segments, and data elements valid for Read More →

EDI GLN

Map Use of GLN And GTIN in Order-to-Cash Transactions The use of GLN in a transaction will occur in the N1 loop. The N1 loop is used to identify organizational entities associated with the transaction. The N1 loop can be repeated to add more than one entity, and/or more than one identifier per entity. The N1 Read More →