EmblemHealth Electronic Claims

EmblemHealth Electronic Claims Submission Requirements EmblemHealth Electronic Claims should not be duplicated. When duplicate claims are submitted, vendor potentially delays claims processing and create confusion for the member. Attachments cannot be submitted electronically at this time. However, most claims should be submitted electronically. If supporting documentation is required for the settlement of a vendor claim, EmblemHealth will request it. Read More →

Electronic Remittance Advice

Electronic Remittance Advice And Electronic Funds Transfer for EmblemHealth Claims Electronic Remittance Advice and Electronic Funds Transfer are the standards for receiving EmblemHealth payments. Electronic Remittance Advice can be processed via PNC Remittance Advantage, a no-cost online payment solution that helps your office reduce payment processing expenses and improve cash flow. With PNC Remittance Advantage, you can receive Read More →

National Provider Identifier

National Provider Identifier Requirements (EmblemHealth Electronic Claims Submission) National Provider Identifier (NPI) should be checked by vendor practice management system to ensure vendor software is capturing and correctly populating a National Provider Identifier (NPI) in electronic claims, otherwise claims will be rejected by EmblemHealth. Please note the following NPI requirements for electronic health care claim submissions: Professional Provider Read More →

Benefits Of Electronic Claims

Benefits Of Electronic Claims Submissions At (Highmark Billing & Payment) Benefits Of Electronic Claims – convenient, confidential, and operational around the clock. All it takes is a computer, the proper software, and an Internet connection for electronic claims submission. Instead of printing, bundling, and sending paper claims through the mail, simply enter and store claims data through your Read More →

Claims Submission Procedures

Claims Submission Procedures (First Time Submission Guidelines) Claims Submission procedures should be followed once vendor has met Manitoba Health requirements using a new Electronic User Site Number. At this time, Manitoba Health will review any areas of concern that were noted during the testing process and address vendor questions relating to handling reduced, rejected and returned claims. Any additional practitioners that join Read More →

Claims Submission

Claims Submission Via 837 File Guidelines (Alliance Behavioral Healthcare) Claims Submission Via 837 HIPAA compliant EDI file is available for poviders, including hospital facilities. Once an agency is EDI Certified, a secure FTP login and password will be assigned. 837s may be submitted using this Claims Submission method or by uploading the file through the provider portal using Read More →

Medicare Electronic Options

Medicare Electronic Options: Transactions Increasing Business Productivity Medicare Electronic Options which will increase your business’ productivity include Claim Status Inquiry (CSI), payable Certificate of Medical Necessity (CMN) status, Beneficiary Eligibility (BE), 270/271, 276/277, and Electronic Remittance Advice (ERAs). Claim Status Inquiry (CSI) Claim Status Inquiry (CSI) allows you to electronically check the status of production claims after they have Read More →

Common Electronic Date Interchange

Common Electronic Date Interchange (CEDI): Handling Medicare Transactions Common Electronic Date Interchange provides a single front end solution for the submission and retrieval of DME MAC electronic transactions. The Common Electronic Data Interchange contract for EDI services for all DME MAC suppliers. The acceptable HIPAA compliant format is the American National Standards Institute (ANSI) X12N Version 4010A1 837 transaction Read More →

Medicare Electronic Data Interchange

Medicare Electronic Data Interchange: Benefits And Advantages Medicare Electronic Data Interchange (EDI) is the computer-to-computer electronic exchange of Medicare files using standard format. Medicare Electronic Data Interchange gives the ability to transmit Electronic Media Claims (EMC) to Medicare in a Health Insurance Portability and Accountability Act (HIPAA) compliant format. National Government Services administers The Common Electronic Data Interchange (CEDI) contract Read More →