TMHP EDI Claims Submission Methods TMHP EDI Claims from providers can be submitted either using software (to submit files directly to TMHP) or they may use a billing agent (i.e., billing companies, vendors, or clearinghouses) that submits files on the provider’s behalf. TMHP EDI Claims Submission – Software Providers that intend to use TMHP’s electronic … Read More →
TMHP EDI Overview and Advantage of Electronic Services (Texas Medicaid & Healthcare Partnership) TMHP EDI program and the Health and Human Services Commission (HHSC) encourage providers to submit claims and other requests electronically. Providers can participate in the most efficient and effective method of submitting requests to TMHP by submitting through the TMHP Electronic Data Interchange (EDI) … Read More →
HIPAA 837 Transaction IEHP Business Scenarios (Examples) and Frequently Asked Questions HIPAA 837 Transaction IEHP Business Scenarios described will be useful for partners Submitting HIPAA 837 Transaction to IEHP. Example 1- IPA Submitting Institutional Encounter Data Encounter data must be submitted by IPAs for all covered services provided to assigned Capitated members. Covered services include PCP visits … Read More →
IEHP EDI Functional Acknowledgement/Reports (837 Health Care Claim: Professional Transaction) IEHP EDI Functional Acknowledgement/Reports – TA1 – Interchange Acknowledgement – enables the receiver to notify the sender when there are problems with the interchange control structure. As the interchange envelope enters the EDFES, the EDI translator performs TA1 validation of the control segments/envelope. The sender will only receive a … Read More →