Electronic Medical Claims Transmission Requirements (CGS Medicare) EDI gives you the ability to transmit Electronic Media Claims (EMC) to Medicare in a Health Insurance Portability and Accountability Act (HIPAA) compliant format. Electronic Data Interchange (EDI) will simplify time-consuming, labor-intensive jobs and ultimately enable you to increase your productivity. The following are a few of the benefits … Read More →
Summa Care 834 Eligibility Enrollment and Maintenance Guides All Trading Partners must complete the EDI registration process before sending any transactions to SummaCare. Furthermore, all sponsors are required to file a change in registration with SummaCare when the following occurs: Changes in Clearinghouse, Billing Service, Software Vendor or any Vendor handling the Sponsor’s electronic data … Read More →
HIPAA Security Requirements For Medicare Trading Partners A/B MACs, DME MACs, CEDI, and other entities contracting directly with CMS are considered service providers to CMS. As such, these entities are part of CMS’ system security boundary and must be in compliance with the Federal Information Security Management Act (FISMA) and are subject to CMS security … Read More →
WCMBP Trading Partner Testing Procedures (Office of Workers’ Compensation Programs) Completion of the testing process is not mandatory prior to submitting electronic transactions to WCMBP. However, it is strongly recommended to ensure proper billing and prompt medical bill processing and payment. Testing is conducted to ensure the following HIPAA compliance levels: Level 1 Syntactical integrity: Testing of … Read More →