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 →

Public Review Period

Announcing a Public Review Period for the 270/271 Health Care Eligibility/Benefit Inquiry and Information Response Announcing A Public Review Period for Health Care Eligibility/Benefit Inquiry and Information Response (270/271) Implementation Guide (007030X332) and the Code Value Usage in Eligibility Benefit Inquiry and Subsequent Response (007030X347) is planned for public review beginning July 16, 2018. The review period will Read More →

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HIPAA 271 Premium Grace Period Notification: Determining Transaction Compliance with Industry Usage Requirements HIPAA 271 Premium Grace Period Notification transmitted transaction complies with the governing implementation guide when it satisfies the requirements as defined within the implementation guide. Specifically, the presence or absence of an item (loop, segment, or element) complies with the industry usage specified by this implementation Read More →

271 Premium Grace Period Notification

271 Premium Grace Period Notification: Industry Usage Instructions 271 Premium Grace Period Notification (HIPAA 007030X344) industry usage instructions describe when loops, segments, and elements are to be sent when complying with the transaction implementation guides. The three choices for usage are required, not used, and situational. To avoid confusion, these are named differently than the X12 standard Read More →

HIPAA 007030X344 271

HIPAA 007030X344 271 Premium Grace Period Notification: Presentation Examples HIPAA 007030X344 271 Premium Grace Period Notification implementation guides use a format that depicts both the generalized standard and the insurance industry-specific implementation. The ASC X12 standards are generic. For example, multiple trading communities use the same PER segment to specify administrative communication contacts. Each community decides which elements to Read More →

enrollment

271 Premium Payment Grace Period Notification 7030 Basics: Health Care Transaction Flow 271 Premium Payment Grace Period Notification 7030 transaction flow subjects to ASC X12 implementation rules for health care electronic transactions. Each ASC X12 implementation guide explains how to use ASC X12 transaction sets to meet a single defined business purpose. The following diagrams depict the business functions supported by Read More →

7030 271 Premium Payment Grace Period Notification

7030 271 Premium Payment Grace Period Notification: Business Usage 7030 271 Premium Payment Grace Period Notification transaction is intended to meet the particular needs of the health care industry for the reporting of premium payment grace period information from a health plan to a provider. While usage may differ in frequency, this transaction is designed to operate in three Read More →