EDI Translator Reports and Edits (New Jersey Medicaid Transaction Submission) New Jersey Medicaid validation of HIPAA interchanges will be done at four different levels of processing. The type of notification to the submitter will depend on where in the process the editing is completed. The first level of editing will be at the point of … Read More →
HIPAA Testing Specific Requirements (New Jersey Medicaid) HIPAA Testing Specific Requirements are offered by New Jersey Medicaid as stated in the NJ Medicaid HIPAA Companion Guides. Submitters wishing to test the NJ specific requirements must have an approved EDI Agreement on file with DXC Technology including a valid HIPAA Certification for the transaction type they wish … Read More →
HIPAA Testing and Certification (New Jersey Medicaid 5010 Guides) HIPAA Testing and Certification requires each prospective electronic data interchange (EDI) submitter to be certified and approved before HIPAA transactions will be processed in production. The Workgroup for Electronic Data Interchange (WEDI), through a collaborative healthcare industry effort called the Strategic National Implementation Process (SNIP), has … Read More →
New Jersey Medicaid HIPAA 5010 Version Updates New Jersey Medicaid signifies its ongoing effort to adhere to the HIPAA transaction set requirements. HIPAA provides all healthcare entities a tremendous opportunity to realize many administrative and systemic benefits because it provides a national standard of transaction and code sets for the electronic exchange of healthcare information. New … Read More →
HIPAA Claims Submission: Intermediary Service Providers can submit claims directly to third party insurers if their software systems have been upgraded to comply with the EDI standards. This approach helps the provider to maintain the maximum amount of control over the claims submission and payment review process, but also necessitates the maintenance of a more … Read More →
HIPAA Electronic Data Interchange (EDI) Rule (The American Speech-Language-Hearing Association) HIPAA Electronic Data Interchange Rule is very technical and based on the X12N EDI data transmission protocol standard. Although rare allowances are made, the rule requires that any covered entity who electronically transmits data must use this, and only this format in doing so. The … Read More →
EDI X12 Structure: Interchange Control Header (ISA) EDI X12 Structure will be analyzed on the the EDI 850 example document (Purchase Order). This particular EDI file contains two purchase orders from a retailer to a supplier, sent on 11/01/2005. Now you see why EDI transactions are primarily handled by computers. But with a little practice after our webinars you’ll … Read More →
HAP Midwest Health Plan Billing And Reimbursment Requirements HAP Midwest Health Plan Billing and Reimbursment process will be discribed below in this blog. MDCH contracts with HAP Midwest Health Plan to administer the Medicaid HMO benefits to its enrolled members. Medicaid is considered as payment source of last resort. Some Medicaid members have dual insurance coverage. … Read More →
Pharmaceutical EDI Data Integration capabilities at McKesson Pharmaceutical EDI Data integration enables configurable pharmaceutical product and data sharing between pharmacy management systems, provider information systems and enterprise resource planning (ERP) systems. McKesson provides data interface solutions for pharmacy customers who are unable to support direct, automated electronic data interchange (EDI) through McKesson Data Exchange module. Solutions allow … Read More →
EDI Webinars Schedule 2020 EDI Training webinars are a perfect opportunity to dive into basics of Electronic Data Interchange, improve your EDI knowledge and get company staff trained with certification. Choose a bundle and save 20%. The best dates and prices for you in the coming year! All Industries – EDI Fundamentals & Best Practices – San … Read More →