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 →
CMS Net Provider EDI (Children’s Medical Services Network Provider Electronic Data Interchange) CMS Net Provider EDI is a web-based tool that enables approved CCS and GHPP providers and Medi-Cal Managed Care Plans to electronically access the status of Requests for Services/Authorizations. Providers and plans have access to view service authorizations, have the ability to print service authorizations, denial … Read More →
SelectHealth EDI Claims Submission – Basic Transactions SelectHealth EDI Claims can be sent electronically through an Electronic Data Interchange (EDI) instead of submitting claims by mail. Claims submitted electronically are typically more accurate and allow to reimburse more quickly. EDI is more than just claims, however. Through EDI transactions, you can also receive remittance advice, eligibility, and … Read More →
Response Files Operational Procedures Response Files like 999 Functional Acknowledgement file will be generated within one business day. To verify if the file was accepted or rejected at this level, look for the IK5 and AK9 segments. If these two segments are followed by an ‘A’ the file was accepted. If these two segments are followed by an … Read More →