Clean Claims EDI Processing and Other Health Coverage Cases Clean Claims will be processed by San Francisco Health Plan as submitted in a timely manner for medically necessary and covered services by a participating provider group in accordance with the agreement between SFHP and the provider group for the applicable benefit program. Clean Claims are … Read More →
San Francisco Health Plan EDI Claims: Common Requirements San Francisco Health Plan EDI Claims are processed for the following medical groups: San Francisco Community Clinic Consortium, San Francisco Health Network (previously known as the Community Health Network) and UCSF Medical Group. Any delegated medical group must submit encounter EDI data to San Francisco Health Plan … Read More →
Transportation EDI Solutions: Key Benefits and Advantages Transportation EDI solutions were applicable in global business for years. Though in early years electronic processing was not known as EDI, today this approach has strong history and continues to develop quickly. Electronic data interchange was already used in automotive and trucking industries many years ago, however, today … Read More →
Medical Codes Overview San Francisco Health Plan uses medical codes according to Medi-Cal billing guidelines in addition to Optum coding books application for claim activities. The following procedure medical codes must be used for a claim to be processed: Professional charges – HIPAA compliant HCPCS Level 1 (CPT) & level 2 Inpatient hospital/facility/institutional charges – … Read More →