Successful Submission of EDI Claims (Louisiana Healthcare Connections Guides)
Steps for successful submission of HIPAA Claims:
- Select clearinghouse to utilize.
- Contact clearinghouse to inform them you wish to submit electronic claims to Louisiana Healthcare Connections.
- Inquire with the clearinghouse what data records are required.
- Verify with Louisiana Healthcare Connections Customer Service Department that the provider is set up in the Louisiana Healthcare Connections system before submitting EDI claims.
- You will receive two reports from the clearinghouse. Always review these reports daily. The first report will be a report showing the claims that were accepted by the clearinghouse and are being transmitted to Louisiana Healthcare Connections and those claims not meeting the clearinghouse requirements. The second report will be a claim status report showing claims accepted and rejected by Louisiana Healthcare Connections. Always review the acceptance and claim status reports for rejected claims. If rejections are noted, correct and resubmit.
- Most importantly, all claims must be submitted with provider identifying numbers. See the CMS 1500 (8/05) and UB‐04 1450 claim form instructions and claim forms for details.
Provider identification number validation is not performed at the clearinghouse level. The clearinghouse will reject claims for provider information only if the fields are empty.
To learn more about EDI and become a certified EDI Professional, please visit our course schedule page.