PIE (PAYER INITIATED ELIGIBILITY/BENEFIT): Requirements of The Deficit Reduction Act Scope (Washington State Medicaid) PIE (Payer Initiated Eligibility/Benefit) transaction was developed to deliver membership and benefit information in one single, unsolicited transaction. The PIE (Payer Initiated Eligibility/Benefit) Transaction uses the same identifiers as the ASC X12 271 response transaction and therefore mirrors the format of the … Read More →
Payer Initiated Eligibility/Benefit (PIE) Within The Requirements of The Deficit Reduction Act Scope (Washington State Medicaid) Payer Initiated Eligibility/Benefit (PIE) electronic transaction can be used by health plans to transmit eligibility and benefit information to Washington State Medicaid. basic guidelines given below are to assist State Medicaid agencies and payers in implementing the Payer Initiated Eligibility/Benefit (PIE) Transaction. … Read More →
EDI Testing CAQH CORE 153 Trading Partner Guidelines EDI Testing CAQH CORE 153 Basics must be combined when determining the overall CAQH CORE Connectivity requirements. Find the fourth part of EDI Testing CAQH CORE FAQs for trading partners below. 1.For batch response pick-up, does CAQH CORE intend for this to be a programmatic interface or a human interface? Under … Read More →
CAQH CORE 153 EDI Payload ID Basics (Connectivity Rule) CAQH CORE 153 EDI Payload ID Basics must be combined when determining the overall CAQH CORE Connectivity requirements. Find the first part of FAQs for trading partners below. 1.Is the payload ID outside the X12 interchange? Yes. 2. Is the payload ID generated and sent by the … Read More →