HIPAA EDI Training

HIPAA EDI Training 2019 Dates

HIPAA EDI Training classes are taught by highly-qualified EDI professionals. All of them have at least 10 years of industry experience.

  • January 31-February 1st, 2019
  • May 16-17, 2019
  • September 19-20, 2019
  • December 5-6, 2019

Classes typically run from 9:30 AM to 4:00 PM
Registration Fee: Early – Bird $1,500. Late Registration $1,800

Training Location In San Diego California 4445 Eastgate Mall, Suite 200, San Diego, CA, 92121

HIPAA EDI Training Mapping Best Practices

In this training session you will also learn a lot of mapping best practices, for example, connecting elements/segments at the same hierarchal level is very important. For example, you will learn to connect header level segments on the input side to the header level segments on the output side of a map, you will also learn how to map detail-to-detail, and summary-to summary sections.

In this section we will also cover the best practices of connecting elements/segments with the same data type. For example, you will learn how to map from numeric fields to numeric fields, date-to-date, string-to \-string. The instructor will illustrate the importance of using the same data type in both the input and output section the same map when possible. In the process of mapping the instructor will explain that all segments/elements on the input side of the map will be in the file.

Introduction to EDI

  • Health Care EDI Defined
  • Benefits of Health Care EDI
  • X12 Standards
  • X12N Workgroups
  • WEDI – Workgroup for Electronic Data Interchange
  • Software & Infrastructure for EDI (What’s a Translator & Mapper)
  • EDI Connectivity (e.g. SFTP, HTTPS, Web Services)

EDI Enveloping & TR3 Viewing

  • EDI Enveloping ISA-GS-ST-SE
  • Key terms related to the structure of EDI (e.g. qualifier, segment, terminator, delimiter)
  • Instructions on using the TR3 manual to look at transactions, segments and data elements, situational rules and loops.
  • LOOP IDs – Deep Dive (HL, NM1,CLM,etc)
  • Instructions on viewing EDI Implementation Guides and Mapping Specs
  • Health Industry Related Code Sets – Clinical and Non-Clinical

Deciphering HIPAA EDI Transactions – Enrollment & Eligibility

  • Deciphering 834 Benefit Enrollment 005010X220A1
  • 834 Update File
  • 834 Audit File
  • 834 Exchange Enrollment 005010X307
  • 820 Premium Payment 005010X218
  • Deciphering 270-271 Eligibility Enquiry and Response & 271 005010X279A1
  • 270 Eligibility Inquiry
  • 271 Response To Eligibility Inquiry
  • 278 Prior Authorizations and Referral Authorizations
  • CAQH Requirements – Real Time & Batch

Deciphering EDI Transactions – 837 Claims & Acknowledgements

  • 837 Professional Claim 005010X222A1
  • 837 Institutional Claim 005010X223A2
  • 837 Dental Claim 005010X223A2
  • TA1 Acknowledgment
  • 999 Acknowledgement 005010X231
  • 277CA Claim Acknowledgment 005010X214
  • Medicare MAO Acknowledgments
  • 276-277 Claim Status Inquiry & Response 005010X212

Deciphering EDI Transactions – 835 Health Care Claim Payment/Advice

  • Deciphering 835 005010X221A1
  • Claim Adjustment Group Codes
  • Claim Adjustment Reason Codes
  • Line Level Balancing
  • Claim Level Balancing
  • Transaction Level Balancing
  • Provider Level Adjustments
  • 835 Best Practices.

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