CMS Net Provider EDI

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

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

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 →

File Transmission

File Transmission (Claims File Exchange Via SFTP Server) File Transmission by IEHP is released via a secure SFTP server for all claims file exchanges. Each direct submitter is assigned an account and a home directory on the SFTP. Within this home directory are several subfolders, each of which serves a specific purpose: sftp.iehp.org – [Home Directory] – 5010 – Read More →