Submitting Electronic Transactions

Submitting Electronic Transactions to HMSA (General requirements)

Submitting Electronic Transactions to HMSA partners should remember that  each transmission to HMSA should have a unique Interchange Control Number (ISA13). HMSA will use this number to determine if it is a duplicate file. HMSA will only accept one interchange (ISA/IEA) per input file from a submitter. There can be multiple functional groups (GS/GE) within one interchange (ISA/IEA). There can be multiple transaction sets (ST/SE) in a functional group (GS/GE). There can be multiple claims (with a recommended upper limit of 5000 claims) in each transaction set (ST/SE).

HMSA will edit down to the claim level. If a claim does not comply with the HIPAA Implementation Guide requirements, the claim will be rejected.

HMSA wants only one type of GS08 value (or only one type of transaction set) in any file sent to HMSA. Do not use the following characters in any string data element:

  • Asterisk “*”
  • Equal sign “=”
  • Pound sign “#”
  • Not symbol “^ “

Formats are subject to change and HMSA will give 90 days notice before any format changes are made.

The 999 Functional Acknowledgment has been designed to allow trading partners to establish an automated control function as a part of their business exchange process. This transaction is not mandated by HIPAA but can be used to identify the acceptance or rejection of functional groups and transaction sets based on a syntactical analysis of the submitted data. Currently, the 999 reports level 1 and level 2 errors based on the guidelines developed by the Strategic National Implementation Process (SNIP).

A provider could be notified that a functional group or transaction set was rejected after the receipt of a 999 that indicated the functional group or transaction set was accepted. This situation is caused by transactions that contain level 4 errors, which are currently not reported in the 999. The trading partner is responsible for retrieving and translating the 999. Errors must be corrected before the transaction (s) is resubmitted.

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