837 Professional and Institutional Claims Notes (Washington State Medicaid processing for Washington State HCA) 837 Professional and Institutional Claims implementation guides are represented for each mandated transaction and modified by authorized Addenda. When accepting 837 Encounters transactions from trading partners, HCA follows HIPAA standards. These standards involve Interchange (ISA/IEA) and Functional Group (GS/GE) Segments or “outer … Read More →
EDI 837 Dental Healthcare Claim Set-up, Directory and File Naming Notes EDI 837 Dental Healthcare Claim set-up requires establishing connections through the SFTP server with further instructions on SFTP usage. SFTP Directory Naming Convention There would be two categories of folders under Trading Partner’s SFPT folders: TEST – Trading Partners should submit and receive their test files … Read More →
Announcing a Public Review Period for the 270/271 Health Care Eligibility/Benefit Inquiry and Information Response Announcing A Public Review Period for Health Care Eligibility/Benefit Inquiry and Information Response (270/271) Implementation Guide (007030X332) and the Code Value Usage in Eligibility Benefit Inquiry and Subsequent Response (007030X347) is planned for public review beginning July 16, 2018. The review period will … Read More →
837 Institutional Healthcare Claim Testing (Washington State Health Care Authority (HCA)) Procedure 837 Institutional Healthcare Claim Testing completion must occur prior to submitting electronic transactions in production to Washington State Health Care Authority ProviderOne. 837 Institutional Healthcare Claim Testing is conducted to ensure the following levels of HIPAA compliance: Level 1 – Syntactical integrity: Testing of … Read More →