Midwest Health Plan EDI Claims General Guidelines Midwest Health Plan EDI Claims Department endeavors to assure prompt and accurate claim and encounter review, processing, adjudication and payment. This is accomplished through the development of Midwest Health Plan EDI claims processing systems, pre-payment and post-payment audits, policies, and procedures that are consistently and appropriately applied. Midwest … Read More →
837 Guides – HIPAA Compliance and Timing 837 Guides described below concern HIPAA agreement and processing time. Find general information about 837 transaction here and more specific notes about mapping practice in the earlier post. Health Care providers with 25 or more full time employees must submit claims electronically using the 837 transaction set. HIPAA 837 Guides mandate that … Read More →
Phoenix Health Plan EDI Claims Submission Guidelines Phoenix Health Plan EDI department encourages providers to consider electronic claims submission (EDI – 837) for your practice. There are many advantages to submitting Phoenix Health Plan EDI claims electronically (decreased submission costs, faster processing and reimbursement, allows for documentation of timely filing, etc). However, any claims requiring attachments, … Read More →
EDI Data Integration Methods And Guides EDI data integration is an essential part of any successful Electronic Data Interchange business implementation. EDI data integration is needed because most business applications will accept an EDI transaction in its raw format for processing. This means there has to be integration software in the middle that will map the EDI transaction into the … Read More →