EDI Claims Processing

WellFirst EDI Claims Processing Guidelines WellFirst Health requires providers to use the correct and complete member number. Families share the first nine digits of their subscriber number. The remaining two digits signify the individual member (i.e. spouse, dependents, etc.). Using the correct member numbers on the claims submitted to WellFirst Health will help to ensure Read More →

wellfirst edi

Electronic Data Interchange (EDI) For Providers WellFirst Health WellFirst Health offers HIPAA-compliant electronic transactions to providers to meet consistent documentation, handling and privacy standards as well as for efficiency. Eligibility and Benefit Inquiry and Response (270/271) The most timely and accurate way to confirm a member’s benefits and coverage amounts is to submit an eligibility Read More →

HIPAA EDI 7030 Standard

Development HIPAA EDI 7030 Standard Training EDI Academy started developing a curriculum for the Health Care HIPAA EDI 7030 Standard. While there is still no go-live date for the 7030, we have been busy creating gap analysis courses between 5010 and 7030.  HIPAA EDI Webinar 420: 7030-5010 Migration Introduction will be the first webinar of Read More →

Change Healthcare EFT Enrollment

EFT Enrollment Process at Change Healthcare Electronic funds transfer (EFT) payment options help save time and simplify reconciliation. ePayment Solutions help to maximize revenue and profit, reduce costs and errors, and increase payment efficiency. Learn more about the EFT service offering. Check out Change Healthcare’s Payer List to see all available EFT-enabled payers. Obtain the EFT Read More →

HIPAA Training

HIPAA Training Types: Training Requirements for Employers and Students Typically, the HIPAA training applies to employers that are HIPAA Covered Entities or Business Associates. Qualifying employers must provide HIPAA training to all employees regardless of their role within the organization as per the Administrative Safeguards of the HIPAA Security Rule. If an employer is engaged in Read More →

HIPAA Compliance

HIPAA Compliance Rules For The Covered Entities and Business Associates  HIPAA has lots of elements and requirements that make a general set of rules called HIPAA Compliance. Let’s discuss, what is HIPAA Compliance and to whom it may refer. This type of compliance means fulfilling the requirements and guidelines of the Health Insurance Portability and Read More →

HIPAA Privacy Rule

HIPAA Privacy Rule: How does HIPAA apply to employers? The question “Does HIPAA Apply to Employers” is one that has provoked many responses due to the complicated nature of the HIPAA Privacy Rule. The HIPAA Privacy Rule is one of the most complicated pieces of legislation affecting the healthcare industry. Because of its objectives to Read More →

HIPAA training

May a HIPAA covered entity or business associate use a cloud service to store or process ePHI? In this blog, we will give a HHS explanation for using cloud services for storing and processing sensitive information. Provided the covered entity or business associate enters into a HIPAA-compliant business associate contract or agreement (BAA) with the Read More →

Protection Of Electronic Health Information

HHS Rules About Protection Of Electronic Health Information The HIPAA Privacy, Security, and Breach Notification Rules (the HIPAA Rules) establish important protections for individually identifiable health information (called protected health information or PHI when created, received, maintained, or transmitted by a HIPAA covered entity or business associate), including limitations on uses and disclosures of such information, safeguards against inappropriate uses Read More →

HIPAA & Cloud Computing

HHS Guidance on HIPAA & Cloud Computing With the proliferation and widespread adoption of cloud computing solutions, HIPAA covered entities and business associates are questioning whether and how they can take advantage of cloud computing while complying with regulations protecting the privacy and security of electronic protected health information (ePHI).  This guidance assists such entities, Read More →