Traceability In Healthcare

GS1 Healthcare Case Study: Improving patient safety through traceability initiative Sanatorio Güemes is a 522-bed private hospital in Buenos Aires, Argentina, that has established best practices regarding patient safety and quality of care. The hospital has implemented processes and policies to enable electronic medical records and improve inventory management, and are meeting many requirements of the National Read More →

GS1 Standards

Transformation with GS1 Standards: Franciscan Missionaries Case Study The Franciscan Missionaries of Our Lady Health System (FMOLHS) is a non-profit healthcare system serving more than half of Louisiana’s population. Challenged by the rising costs and growing complexity of delivering quality healthcare, FMOLHS needed to improve its operational efficiencies, control costs, and remain focused on what mattered most—the 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 Statusing

EDI Claims Statusing On The HAP Midwest Health Plan Website EDI Claims Statusing is provided for all HAP Midwest Health Plan providers.  EDI Claims Statusing can be tracked 24/7 on website at www.midwesthealthplan.com. Midwest Health Plan EDI Claims Statusing gives you the possibility to status up to three years of claims data. EDI Claims Statusing procedure Click on Read More →

Clean Claim Requirements

Clean Claim Requirements (Cigna vendors) Clean Claim Requirements were developed with the goal to process all claims at initial submission. Before Cigna can process a claim, it must be a “clean” or complete claim submission, which includes the following information, when applicable: primary carrier explanation of benefits (EOB) when Cigna is the secondary payer prescription for physical Read More →

Pharmaceutical EDI Data Integration

Pharmaceutical EDI Data Integration capabilities at McKesson Pharmaceutical EDI Data integration enables configurable pharmaceutical product and data sharing between pharmacy management systems, provider information systems and enterprise resource planning (ERP) systems. McKesson provides data interface solutions for pharmacy customers who are unable to support direct, automated electronic data interchange (EDI) through McKesson Data Exchange module. Solutions allow Read More →

Claims EDI Processing

HIPAA EDI Legislative Background In The Healthcare Business EDI is the process of using nationally established standards to exchange electronic information between business entities. These national standards are developed and maintained by a group of standards development organizations (SDOs), such as the Accredited Standards Committee (ASC) X12 and the National Council of Prescription Drug Programs Read More →

HIPAA EDI Acronyms

HIPAA EDI Acronyms and Definitions Learn basic HIPAA EDI acronyms and definitions to understand the terminology used in health care CMS guidelines. EDI – Electronic Data Interchange – the process of using nationally established standards to exchange electronic information between business entities. HIPAA – Health Insurance Portability and Accountability Act of 1996 – legislation that mandated that Read More →

HIMSS-OMB-Blog_Updated

EDI Enrollment and Registration (AKA Trading Partner Agreements) Medicare FFS’ Trading Partner Agreement is comprised of two forms: 1) EDI Registration and 2) EDI Enrollment. The forms are identified under CMS form 10164 and can be accessed at: EDI Registration EDI Enrollment A/B MACs and CEDI must use these two forms, or their own organization Read More →

HIPAA EDI Standard

HIPAA EDI Standard History EDI is the process of using nationally established standards to exchange electronic information between business entities. These national standards are developed and maintained by a group of standards development organizations (SDOs), such as the Accredited Standards Committee (ASC) X12 and the National Council of Prescription Drug Programs (NCPDP). The Department of Health Read More →