837P Claim

837P Claim Form CMS-1500: Implementation Guides 837P Claim (Professional) is the standard format used by health care professionals and suppliers to transmit health care claims electronically. The Form CMS-1500 is the standard paper claim form health care professionals and suppliers use to bill Medicare Administrative Contractors (MACs) when a paper claim is allowed. Centers for Read More →

IEHP 5010 837I Institutional Claim

IEHP 5010 837I Institutional Claim Transaction Basics IEHP 5010 837I Institutional Claim requirements are given below for providers submitting health care claims to IEHP via EDI Network and for those who are intended to start EDI exchange with IEHP. Clearinghouse/IEHP Direct Providers Submitting Claim Data Clearinghouses are largely used as an intermediary for fee-for-service Providers, hospitals, and other Providers submitting Read More →

837 Health Care Claim

837 Health Care Claim Technical Procedures And Infrastructure (IEHP Provider Network) 837 Health Care Claim: Professional Transaction must be transmitted by business partners to IEHP by connecting to the IEHP Network. They go from the Internet through a Virtual Private Network (VPN) tunnel to the IEHP Secure File Transfer Protocol (SFTP) Server. In standard software-to-hardware VPN connections, VPN client Read More →

healthcare-technology

EDI 837 Common Ground Healthcare Cooperative Highlights EDI 837 Common Ground Healthcare Cooperative transaction requires efficient and accurate electronic transaction processing. To promote this EDI partners should note: Each user is assigned a 6-digit EDI Direct Trading Partner ID. Logon User Name is 8 characters. Logon User ID (password) is 9 characters. All dates are in the CCYYMMDD format. Read More →

837 Institutional Healthcare Claim

837 Institutional Healthcare Claim Testing: Set-up, Directory and File Naming 837 Institutional Healthcare Claim Testing should be followed by requesting information on establishing connections through the SFTP server. Upon completion of 837 Institutional Healthcare Claim set-up, providers will receive additional instructions on SFTP usage. SFTP Directory Naming Convention There would be two categories of folders under Trading Read More →

HIPAA Dental COB Claim

 HIPAA Dental COB Claim Mapping Exercise Example HIPAA Dental COB Claim example and exercise represent how to generate HIPAA Dental COB Claim file for processing by the destination payer. HIPAA Dental COB Claim Scenario Patient PUFFY DOG is seen a dentist DONALD D, DUCK in the office INFINITE ENDODONTICS. The payer of the HIPAA Dental COB Claim is Read More →

Без названия

837 Professional Healthcare Claim (Washington State Medicaid Trading Partners Requirements) 837 Professional Healthcare Claim guidelines can 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. Testing is conducted to ensure the following levels Read More →

Compliance Checking

EDI Compliance Checking For X12, EDIFACT And HIPAA Standard Requirements EDI Compliance Checking is the process of incoming and outgoing X12/EDIFACT/HIPAA documents validation. The documents are being checked for compliance with the established and agreed formats. There exist EDI Compliance Checking packs – frameworks that check incoming documents for compliance before they are transformed. After Read More →

MIME

MIME Definition MIME (Multipart Internet Message Extensions) defines a message format (a set of documents) represents a mechanism of sending different file types as one part or together with common mail messages. Multipart Internet Message Extensions has headers that are defined by RFC 822 and extensions to those header definitions. Multipart Internet Message Extensions follows Read More →

Passport Health Plan EDI

Passport Health Plan Electronic Submission Advanatages (for Medical and Hospital Claims) Passport Health Plan Electronic Submission is the initiative for all providers. Passport Health Plan Electronic Submission allows faster, more efficient, and cost-effective claim submission for providers. EDI, performed in accordance with nationally recognized standards, supports the health care industry’s efforts to reduce administrative costs. The benefits Read More →