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 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 →
Announcing a Public Review Period for four X12 837 Implementation Guides, X323, X324, X325 and X326 The following four implementation guides will be available for public review beginning October 15, 2019. The review period will close November 30, 2019 at 8:00 PM, Eastern Time. These guides have been developed by X12’s Insurance subcommittee based on … Read More →
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 (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 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 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 →
Clean Claim Requirements (Cigna vendors) Clean Claim Requirements were developed with the goal to process all claims at initial submission. Before Cigna can process a claim, it must be a “clean” or complete claim submission, which includes the following information, when applicable: primary carrier explanation of benefits (EOB) when Cigna is the secondary payer prescription for physical … Read More →
Cigna Electronic Data Interchange Claims Process Cigna Electronic Data Interchange vendors securely transmit data electronically to Cigna and gain many benefits of this process. Filing paper claims can be time consuming. When you submit claims to Cigna electronically, including coordination of benefits (COB) claims, your practice can gain many benefits such as: Quicker claims submission, including Dental Health … Read More →
Operating Rules CAQH CORE 270: Connectivity Rule Guidelines Operating Rules CAQH CORE 270: Connectivity Rule requirements must be implemented by all entities seeking CORE Certification, including all other the CAQH CORE Eligibility and Claim Status Operating Rules. Operating Rules CAQH CORE 270: Connectivity Rule state that the CAQH CORE 270 Rule is applicable only to the public Internet, which is a TCP/IP … Read More →