No Surprises Act Good Faith Estimate / Advanced EOB Standards-based Approach * Cooperative Exchange, The National Clearinghouse Association Explained On December 27, 2020, the No Surprises Act was signed into law as part of the Consolidated Appropriations Act of 20211, Public Law 116-260. The No Surprises Act (NSA) seeks to protect consumers from surprise medical Read More →

HIPAA claims

Oklahoma Health Care Authority Provider Portal Guides Oklahoma Health Care Authority uses the SoonerCare Provider Portal offering providers several services from submitting claims on the web to fast verification of claim status. The SoonerCare Provider Portal is available 24 hours a day, 7 days a week, except during scheduled maintenance. Find the types of Web Users Read More →

Health Care EDI

Health Care EDI Real World Practice: HIPAA Compliance And Deviations Health Care EDI is one of the branches where Electronic Data Interchange accelerates information exchange, reduces manual interruption and provides processing reliability and security. Health Care EDI operates under the rules of HIPAA – standard that states requirements to health care electronic transactions. HIPAA concerns health care Read More →

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 →