New Jersey Medicaid HIPAA 5010 Version Updates New Jersey Medicaid signifies its ongoing effort to adhere to the HIPAA transaction set requirements. HIPAA provides all healthcare entities a tremendous opportunity to realize many administrative and systemic benefits because it provides a national standard of transaction and code sets for the electronic exchange of healthcare information. New … Read More →
HIPAA Claims Submission: Intermediary Service Providers can submit claims directly to third party insurers if their software systems have been upgraded to comply with the EDI standards. This approach helps the provider to maintain the maximum amount of control over the claims submission and payment review process, but also necessitates the maintenance of a more … Read More →
HIPAA Electronic Data Interchange (EDI) Rule (The American Speech-Language-Hearing Association) HIPAA Electronic Data Interchange Rule is very technical and based on the X12N EDI data transmission protocol standard. Although rare allowances are made, the rule requires that any covered entity who electronically transmits data must use this, and only this format in doing so. The … Read More →
EDI Report Types (Claims Status Awaiting Resolution Option) There are a number of EDI Report Types available to monitor and manage electronic claims. TR reports provide the end-user with information to monitor and manage EDI claims still within the VA, that is, between the VAMC and the FSC in Austin, TX. The MM reports provide the … Read More →