Centers for Medicare & Medicaid Services Adopted Standards and Operating Rules HIPAA required HHS (Department of Health & Human Services) to establish national standards for electronic transactions to improve the efficiency and effectiveness of the nation’s health care system. These standards apply to all HIPAA covered entities: Health plans Health care clearinghouses Health care providers who conduct electronic Read More →

HIPAA Claims

Non-Standard Claims Converted to Standard Claims (HealthLink) If the HealthLink Document Control Number (DCN) begins with an “E”, HealthLink received the claim electronically from a provider. If the HealthLink DCN starts with any other character, the claim was received on paper (or manually). Professional and institutional claims which can be scanned and via imaging made Read More →

EDI training for healthcare

Perfect Order For Improved Patient Care (Mercy Health Case Study) Three years after instituting the Perfect Order program between BD and ROi/Mercy, EDI utilisation remains high and error rates remain very low. In December 2015, 97.64 percent of BD products purchased by ROi/Mercy were via EDI and 96.46 percent of the line items were “touchless,” accounting for some items that Read More →

EDI training

Implementing “Perfect Order” at Mercy Health via EDI and GS1 Standards When ROi/Mercy and BD first began working to establish the perfect order, both companies worked to ensure that every BD product had an established GTIN for every item in Mercy’s item master at each unit of measure. Today, ROi/Mercy leverages these GTINs when ordering, picking and shipping BD products throughout Mercy. Where Read More →