Rocky Mountain Health Plans EDI Program Guides
Rocky Mountain Health Plans EDI initiative was developed for easy and comfortable claims submitting, improving cash-flow, receiving immediate feedback on claims, eliminating mail and handling time for the claims. Rocky Mountain Health Plans EDI initiative allows to reduce administrative expenses (paper, stamps, envelopes) and speed-up claims processing with less errors and failures.
Rocky Mountain Health Plans is an independent, not-for-profit health insurance provider that has served the health care needs of Coloradans for more than 35 years. Rocky Mountain Health Plans EDI system allows providers to submit claims, retrieve remittance advice and claim file acknowledgements from the insurance carrier or clearinghouse. Rocky Mountain Health Plans program promotes fast claims turnaround by accepting electronic claims submission directly from provider offices as well as from many clearinghouses.
To become a partner of the Rocky Mountain Health Plans EDI program and to enroll in electronic claims submission to Rocky Mountain Health Plans you should pass the following steps:
- Get the Electronic Data Interchange Transaction Request Form and complete it.
- Send the completed form to supports@rmhp.org.
- Wait for the call from the Rocky Mountain Health Plans EDI representative.
The following preferred clearinghouses currently send electronic claims data to Rocky Mountain Health Plans EDI. This is not an all-inclusive list:
- ClaimLogic
- Cortex EDI
- CPSI
- Healthcare Administration Technologies, Inc
- McKesson (Also known as Relay Health)
- Navicure
- NDCHealth (Also known as Relay Health)
- Practice Insight
- QuadraMed (Also known as Health Fusion)
- The SSI Group
- ViaTrack Systems.
To comply with changes in the Health Insurance Portability & Accountability Act (HIPPA) security standards, Rocky Mountain Health Plans is required to convert its Electronic Data Interchange (EDI) website to a more secure file transfer protocol (SFTP). To meet these standards, Rocky Mountain Health Plans will be transferring its Legacy Provider EDI website to an SFTP on June 15, 2016. All the business partners who join Rocky Mountain Health Plans EDI must pay attention to this. HIPAA full compliance is another important requirement.