EDI Enrollment Guidelines And Assistance Steps EDI Enrollment steps described in the blog will help Manitoba Health providers to make a smooth transition to a new medical billing system. You will be provided with forms and instructions after contacting Manitoba Health, Healthy Living and Seniors. If you are required to submit ICD-9-CM codes (required on Physician, Nurse Practitioner, Read More →

EDI Worldwide Standards List And Description (Part 2) EDI worldwide standards appeared as business requirements were quite different and diverse, and organizations tried to optimize messaging formats. There are formats used across industries to facilitate business communication. We continue to describe international EDI standard formats. HIPAA (The Health Insurance Portability and Accountability Act). HIPAA EDI is a set of Read More →

EDI Worldwide Standards List And Description (Part 1) EDI worldwide standards appeared when EDI came onto the scene, and companies have attempted to standardize B2B relationships. As business requirements were quite different and diverse, organizations have optimized messaging formats that resulted in a dozen EDI standards in use. There are formats used across industries to facilitate business communication as well Read More →

Electronic Medical Claims Program Requirements (Manitoba Health, Healthy Living and Seniors) Electronic Medical Claims Program requires automation integrated with the current office tasks and procedures to maximize the benefits. An electronic medical billing system should provide your office with more rapid input, improved accuracy, faster processing and the ability to report and analyze practice statistics. Read More →

Claims Submission Via 837 File Guidelines (Alliance Behavioral Healthcare) Claims Submission Via 837 HIPAA compliant EDI file is available for poviders, including hospital facilities. Once an agency is EDI Certified, a secure FTP login and password will be assigned. 837s may be submitted using this Claims Submission method or by uploading the file through the provider portal using Read More →

AlphaMCS Claims And Secondary Claims Processing AlphaMCS Claims can be submitted via a web-based provider portal that allows providers to submit claims to the LME/MCO. Claims can be submitted via a CMS 1500/UB04 or via an 837P/I. The daily cutoff for nightly adjudication is 5pm. The claims are adjudicated nightly. For claims submitted via CMS1500/UB04, the claims status is Read More →

Claim Submission Guidelines For Alliance Behavioral Healthcare Providers (Fiscal Year 2019) Claim Submission guidelines for providers require an attestation for claims submitted through the provider portal. The claim submission deadlines for Medicaid and State contracts are different. Both timelines are stated in the respective contracts and are also listed below. State or Locally Funded Services Original Read More →

Tracking Claims Operation Guides (The American Medical Association (AMA)) Tracking Claims can be used by physician practices. They can submit and resubmit large quantities of claims at one time, in bulk, quickly and efficiently. For example, if categories such as a specific date of service, a date range or a specific patient’s claims are required Read More →