CAQH CORE HTTP/S (250: Claim Status Infrastructure Rule) Connectivity CAQH CORE HTTP/S is secure and reliable enough to protect the delivery of healthcare information over the Internet. In Phase I development discussions, CAQH CORE solicited input on this topic from its Technical Work Group members and experts within healthcare and other industries, such as financial services. Based on Read More →

CERT Contractor EDI Claims Error Checking CERT Contractor may consider claims sent by providers and Medicare partners having errors. Errors may result for the following reasons: No Documentation Received This results when the provider fails to respond to the request for medical records, or responds to the request untimely. In order to avoid these types of Read More →

CERT Program Primary Objectives And Claims Status CERT Program supports CMS’s primary objectives of ensuring that Medicare contractors are paying claims appropriately, and providers are billing medically necessary services correctly. The error results help identify the areas of greatest vulnerability to the Medicare program, and will assist in directing educational activities to reduce the error Read More →

EDI Claim Selection For CERT Review Basic Principles EDI Claim Selection supposes review the bar coded sheet, included with the CERT letter, to determine what documentation is being requested. Keep a copy of the CERT letter, including the bar coded sheet, on file within your agency. Gather all documentation requested in the letter, and any Read More →

EDI Academy invites you to join HIPAA X12 Online Trainings! * $250 per session per person. * 20% discount for all sessions (email info@ediacademy.com). * 20% discount for groups. * 100+ page course manual, other educational resources. HIPAA EDI 101 – Introduction To The Health Care EDI Environment Wednesday, August 15th, 2018 11:00 AM – Read More →

An EDI Thanksgiving Thanksgiving is the beginning of the trifecta of holidays for our family – Thanksgiving, Christmas, and New Year’s. While it is always nice to get out of the regular routine and spend time with family and friends, there are always stresses. For me, it is the unpredictability of the day. I am Read More →

EDI Purchase Order Number (Reference Number for Union Pacific) EDI Purchase Order Number is the key reference number for Union Pacific. It ties together all EDI communications about a purchase, including payment. It is the Supply Department’s responsibility to furnish the supplier with a purchase order number for EDI all purchases. It is the Supplier’s responsibility to use that number in Read More →

EDI Integration: Software Upgrades, Proprietary Data And Legal Concerns EDI Integration requires regular updates. The Rail Industry Guidelines are updated each year upon publication of the ASC X12 version/release. Trading partners within the rail industry are expected to upgrade to one of the two most current version/releases on a schedule agreed to by the railroads. In most Read More →

EDI Implementation Concerns EDI Implementation is not a simple task, EDI is not technically complex. There are a number of ways to learn about EDI, including: periodicals, commercially available training programs, EDI conferences and trade shows, software and network suppliers, and the experience of companies already participating in EDI. Costs and benefits Hardware costs often are Read More →

Testing EDI Transactions (Union Pacific Trading Partner EDI Program) Testing EDI transactions is initiated by Union Pacific to ensure prompt payments and electronic documents processing with trading partners. Union Pacific is currently active in the following EDI transactions (ASC X12): 850 RIFMAT – Purchase orders 810 RIFMAT – Material invoices 810 RIFDFO – Diesel fuel invoices 997 Read More →