EDI Enrollment

EDI Enrollment With Inland Empire Health Plan (IEHP)

EDI Enrollment will be a smooth process, if a completed enrollment form was submitted to the EDI department at IEHP, providing all information need to get started. This includes details about the enrollee, the primary and technical contacts, and the types of claims EDI transactions being requested, 837I/837P/835. If the enrollee will be submitting for multiple Providers, the attached schedule can be used to list the Providers. The enrollment form can also be used when a change is required, such as change of address or a submitter needs to be added or removed from the schedule. The enrollment form can be used to cancel enrollment as well.

Trading Partner Agreement

In addition to the enrollment form, a Trading Partner Agreement (TPA) may be required in some circumstances. In the case that the enrollee will be acting as a third party agent for the claims submitter, such as with a clearinghouse, biller, or bank, a TPA will be needed. This agreement clarifies the HIPAA and HITECH privacy and security responsibilities of IEHP and the enrollee. If a copy of the signed TPA is sent along with the enrollment form by email, the enrollment process can continue without delay.

Submitter ID & SFTP Account 

When the enrollment form and a copy of the TPA have been received, the EDI department will generate a submitter ID and begin configuring the enrollee’s submission details. Credentials on IEHP’s SFTP server will be created based on the submitter ID also. The submitter ID is an important identifier. It should be included in all submitted claims files and will be used for tracking EDI transactions, EDI reporting, and troubleshooting.

SFTP credentials are created by the Help Desk. The SFTP will be used in the exchange of all claims data. The credentials assigned to enrollees will provide access to post claims files and retrieve response files. Security is the highest priority when dealing with healthcare information. Credentials should be kept private.


Leave a Reply

Your email address will not be published.

Post Navigation