Critical EDI Process

Critical EDI Process Terms For EDI Operations With Veterans Health Administration (VHA) Critical EDI process terms will be useful for medical providers that are on the stage of establishing EDI partnership with VHA. 835 Health Care Claim Payment/Advice – The HIPAA adopted standard for electronic remittance advice to report the processing of all claim types (including retail Read More →

Veterans Health Administration EDI

Veterans Health Administration EDI (HIPAA) Requirements Veterans Health Administration EDI Billing provides the VHA with the capability to submit Institutional and Professional claims electronically as 837 Health Care Claim transmissions, rather than printing and mailing claims from each facility. In 1996, Congress passed into law the Health Insurance Portability and Accountability Act (HIPAA). This Act directs the Read More →

Medical billing

Medical EDI Vendors Guidelines Medical EDI Vendors are subjected to successful completion of required testing before live data transmissions begin. Any vendor that does not successfully complete the required testing will not be permitted to submit EDI transactions on behalf of clients. Vendors that successfully complete the required testing will not be required to complete Read More →

Retrieving An EDI File

Retrieving An EDI File From UHA If sender (UHA Trading Partner) provided UHA with an email address, it will receive email notification that files are available for pickup. Each Transmitter will be issued a username and password after a properly completed and signed request form is received and approved by UHA. Use the assigned username and password to login Read More →

Sending an EDI File

Sending an EDI File to UHA (Transmitting Guides) When sending an EDI File to UHA each Transmitter will be issued a username and password after a properly completed and signed request form is received and approved by UHA. Use the assigned username and password to login to UHA’s Secure File Server, by following the steps Read More →

File Transfer Procedures

File Transfer Procedures (UHA EDI Trading Partners): File Naming Convention File Transfer Procedures including File Naming Convention requirements for clearing houses submitting claims for multiple providers and for providers submitting claims directly are described in the blog below. Clearing Houses submitting claims for multiple providers Inbound (to UHA) 837 and Outbound (from UHA) 997 Format: Taaaaa_Sbbbbb_####_mmdd_NN.dat Read More →

UHA Claim Submission

UHA Claim Submission (Trading Partner Guidelines) UHA Claim Submission specific instructions are required for electronic transfer of the claims data via Electronic Data Interchange processing systems. 997 Functional Acknowledgement UHA is required to create a 997 Functional Acknowledgement to report the results of the standard X12 syntax editing. The 997 will normally be available by the next business Read More →

UHA Claim Submission

UHA Claim Submission Requirements For Trading Partners UHA Claim Submission must be processed using the codes required in the National Implementation Guides and the HIPAA rules. Each transmission to UHA should have a unique Interchange Control Number (ISA13). UHA will use this number to determine if it is a duplicate file. b. Submitters are required to submit Read More →

Filing A Healthcare Claim

Filing A Healthcare Claim Requirements For Cigna Vendors Filing A Healthcare Claim should be done as soon as possible. If you’re unable to file a claim right away, please make sure the claim is submitted accordingly. If you are a participating health care provider, submit by 90 days after the date of service If you are Read More →