EDI Billing Set-Up

EDI Billing Set-Up Veterans Health Administration (VHA). Associated Insurance Companies and Copying Physician/Provider Secondary IDs and Additional Billing Provider Secondary IDs

Patch IB*2.0*320 provides the ability for users to associate multiple Insurance Company entries with each other.

Example: If there are 45 Blue Cross/Blue Shield entries in the Insurance Company file, users can make one of these entries the Parent company and make 1 to 44 of the other entries a Child company.

Making these associations will cause the software to automatically make the Physician/Provider Secondary IDs and the Additional Billing Provider Secondary IDs the same for all associated companies. Once these associations are made and the IDs synchronized for all the associated companies, users can Add, Edit, and/or Delete IDs for the associated companies from the Parent company. Changes to the IDs from a Child company, however, are prohibited. If a situation changes and it becomes necessary for a Child company to have IDs that differ from those of the Parent company, users may disassociated the Child company from the Parent company.

  • Designate a Parent Insurance Company

Designate a Child Insurance Company An insurance company can be designated as a Child, from the Parent insurance company. If users want to quickly define a single insurance company as a Child, they can do this from the Insurance Company Editor.

  • Copy Physician/Provider Secondary IDs

Individual Physician/Provider Secondary IDs can be entered, edited or deleted one time from the Parent insurance company and these changes will be copied to all associated insurance companies (Child). This can be done using the following Provider ID Maintenance options:

  1. Provider ID Maint-PI Provider Insurance IDs;
  2. Provider ID Maint-II Insurance Co IDs;
  3. Provider ID Maint-BI Batch ID Entry
  • Copy Additional Billing Provider Secondary IDs

When users are done adding, editing, or deleting Additional IDs from the Parent insurance company, the changes will be copied to all associated insurance companies.

  • Synchronizing Associated Insurance Company IDs

There is an IRM option for synchronizing the IDs of a Parent insurance company with all of the associated Child companies. This option is intended as a back-up option if the IDs of a Parent have become out of synch with the Child companies due to a system problem.

To learn more about EDI Billing and become a certified  Health Care EDI Professional please visit our course schedule page.

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