CAQH CORE 153 EDI

CAQH CORE 153 EDI Connectivity Rule (Eligibility & Claim Status Operating Rules) CAQH CORE 153 EDI Connectivity Rule must be combined when determining the overall CAQH CORE Connectivity requirements. The Part 1 of CAQH CORE 153 EDI Connectivity Rule FAQs is given below. 1. How did CAQH CORE decide that HTTP/S is secure and reliable enough to protect the delivery of Read More →

837 Dental Healthcare Claim

EDI 837 Dental Healthcare Claim Technical Environment Guidelines (Washington State Medicaid) EDI 837 Dental Healthcare Claim technical guides are to be used by members/technical staff of trading partners who are responsible for electronic transaction/file exchanges. Completion of the testing process must occur prior to submitting electronic transactions in production to ProviderOne. EDI 837 Dental Healthcare Claim Read More →

837 Professional and Institutional

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

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 →