EDI DELFORP (Delivery Forecast Planned Delivery) Continental Transaction EDI DELFORP message informs Continental about planned deliveries well in advance. Planned deliveries is designated as ‘planned receipts’ in the following blog post. This message type is required for the Supply Chain Monitor (SC Monitor). The SC Monitor is a web-based monitoring system of the current supply situation. There are three Read More →

Medicare Electronic Options: Transactions Increasing Business Productivity Medicare Electronic Options which will increase your business’ productivity include Claim Status Inquiry (CSI), payable Certificate of Medical Necessity (CMN) status, Beneficiary Eligibility (BE), 270/271, 276/277, and Electronic Remittance Advice (ERAs). Claim Status Inquiry (CSI) Claim Status Inquiry (CSI) allows you to electronically check the status of production claims after they have Read More →

EDI Invoice Recommendations For Belk EDI Suppliers EDI Invoice Total should include the sum of the details plus any Charges, minus any Allowances that you might send on the EDI Invoice. The totals must match or your Invoice will be rejected. You cannot invoice the same UPC at different prices on the EDI Invoice. The Invoice will Read More →

EDI Payer Initiated Eligibility/Benefit Transaction (Washington State Medicaid) Additional Guides EDI Payer Initiated Eligibility/Benefit Transaction transmission must be secure in accordance with 45 CFR Parts 160, 162, and 164 Health Insurance Reform: Security Standards. Control segments/envelopes EDI Payer Initiated Eligibility/Benefit Transaction conforms to ASC X12 Control Segments / Envelopes (ISA-IEA, GS-GE, and ST-SE) for Version Read More →

PIE Transaction (Payer Initiated Eligibility/Benefit) Washington State Medicaid Testing Requirements PIE Transaction should be submitted by the trading partner through the Washington State Medicaid ProviderOne Secure File Transfer Protocol (SFTP). The trading partner downloads acknowledgements for the test file from the ProviderOne SFTP HIPAA ACK folder. If the ProviderOne system generates a positive TA1 and Read More →

PIE (PAYER INITIATED ELIGIBILITY/BENEFIT): Requirements of The Deficit Reduction Act Scope (Washington State Medicaid) PIE (Payer Initiated Eligibility/Benefit) transaction was developed to deliver membership and benefit information in one single, unsolicited transaction. The PIE (Payer Initiated Eligibility/Benefit) Transaction uses the same identifiers as the ASC X12 271 response transaction and therefore mirrors the format of the Read More →

Payer Initiated Eligibility/Benefit (PIE) Within The Requirements of The Deficit Reduction Act Scope (Washington State Medicaid) Payer Initiated Eligibility/Benefit (PIE) electronic transaction can be used by health plans to transmit eligibility and benefit information to Washington State Medicaid. basic guidelines given below are to assist State Medicaid agencies and payers in implementing the Payer Initiated Eligibility/Benefit (PIE) Transaction. Read More →

834 Benefit Enrollment and Maintenance HIPAA Basic Guides (Washington State Medicaid HCA) 834 Benefit Enrollment and Maintenance should be used by trading partners in conjunction with the ASC X12 TR3 834 Benefit Enrollment and Maintenance version 005010X220A1. When transmitting 834 Benefit Enrollment and Maintenance transactions, HCA follows standards developed by ASC X12. These standards involve Interchange (ISA/IEA) Read More →