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 →

Medicare EDI

Medicare EDI Service Overview And Advantages Medicare EDI (Electronic Data Interchange) is the computer-to-computer electronic exchange of business documents using standard format. Medicare EDI gives you the ability to transmit Electronic Media Claims (EMC) to Medicare in a Health Insurance Portability and Accountability Act (HIPAA) compliant format. The acceptable HIPAA compliant format is the American Read More →

TMHP Electronic Billing

TMHP Electronic Billing Setting up Access, Training TMHP Electronic Billing all software vendors and billing agents to complete EDI testing before access to the production server is allowed. Providers must setup their software or billing agent services to access the TMHP EDI Gateway. Providers who use billing agents or software vendors should contact those organizations for information Read More →

TMHP EDI Claims

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

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

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 →

for-physicians-resources-boards-committees

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 →

837 Health Care Claim

837 Health Care Claim: Professional Transaction based on ASC X12 Technical Report Type 3 (TR3) 837 Health Care Claim: Professional Transaction may be transmitted any day of the week to IEHP from a customer’s business partner. The transaction provides data on Medicare Advantage / Part D data. Technical Infrastructure and Procedures Business partners transmitting 837 Health Care Read More →