HIPAA Claim Form

HIPAA Claim Form Requirements: Provider Signature on Claims HIPAA Claim Form CMS-1500, American Dental Association (ADA) Dental Claim Form, and 2017 Claim Form must be submitted with the provider’s or an authorized representative’s handwritten signature (or signature stamp) in the appropriate block of the claim form. Signatory supervision of the authorized representative is required. Providers delegating Read More →

Procedure Coding

HIPAA Claim: Procedure Coding (Texas Medicaid) Texas Medicaid uses the Healthcare Common Procedure Coding System (HCPCS) for HIPAA Claim submission. HCPCS provides health-care providers and third-party payers a common coding structure that uses codes designed around a five-character numeric or alphanumeric base. The procedure codes are updated annually and quarterly. HCPCS consists of two levels Read More →

Health Care Claim

Health Care Claim: Diagnosis Coding (Texas Medicaid) Health Care Claim must be coded by electronic billers. Health Care Claim is processed fast and accurately if providers furnish appropriate information. By coding EDI Health Care Claim, providers ensure precise and concise representation of the services provided and are assured reimbursement based on the correct code. If providers Read More →

837P Claim

837P Claim Form CMS-1500: Implementation Guides 837P Claim (Professional) is the standard format used by health care professionals and suppliers to transmit health care claims electronically. The Form CMS-1500 is the standard paper claim form health care professionals and suppliers use to bill Medicare Administrative Contractors (MACs) when a paper claim is allowed. Centers for Read More →


TMHP HIPAA EDI Claim Guides TMHP HIPAA EDI transactions are assigned an eight-character Batch ID immediately upon receipt by the TMHP EDI Gateway. The batch ID format allows electronic submitters to determine the exact day and year that a batch was received. The batch ID format is JJJYSSSS, where each character is defined as follows: Read More →

TMHP Electronic Claims Submission

TMHP Electronic Claims Submission: Acceptance And Rejection TMHP Electronic Claims submission requires the HIPAA-compliant American National Standards Institute (ANSI) ASC X12 5010 file format through secure socket layer (SSL) and virtual private networking (VPN) connections for maximum security. Providers must retain all claim and file transmission records. They may be required to submit them for pending Read More →

Version 7030

Version 7030 Is Coming – X12 EDI Training Online Schedule 2020-2021 TBD Version 7030 HIPAA EDI training is the most expected educational event in 2020. Follow our news to register for the first training stream. Find the course description below. HIPAA EDI 7030-101 – Introduction To The Health Care EDI Environment & 7030 Introduction to 7030 7030-5010 Major Gaps Read More →

Completing The HIPAA Attachment Cover Sheet

Completing The HIPAA Attachment Cover Sheet (NJ Medicaid Provider Instructions) With the implementation of HIPAA electronic data interchanges in the 837 5010 format these claims may now initially be submitted electronically with the required attachments following in the mail. Find the instructions for completing the HIPAA Attachment Cover Sheet below. Complete all necessary Loops and Segments for Read More →

HIPAA 837 Attachment

HIPAA 837 Attachment Cover Sheet Requirements (New Jersey Medicaid) With the inception of HIPAA, there is a conscious effort to reduce the amount of paper required for claim submission. Previously, claims requiring additional information not provided on the hard copy claim forms or in electronic formats had to be submitted with attachments to provide the additional information Read More →

EDI Acknowledgements

HIPAA Claim Submission Verification – New Jersey Medicaid Companion Guides HIPAA Claim submission verification via TA1 Interchange Acknowledgements will be available to the EDI Submitter upon completion of uploading (dropping-off) their interchanges on the Website as long as the submitter stays connected. If the submitter disconnects immediately after dropping-off their interchange and does not receive their TA1, then Read More →