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: 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 →

837 Institutional Healthcare Claim Testing

837 Institutional Healthcare Claim Testing (Washington State Health Care Authority (HCA)) Procedure 837 Institutional Healthcare Claim Testing completion  must occur prior to submitting electronic transactions in production to Washington State Health Care Authority ProviderOne. 837 Institutional Healthcare Claim Testing is conducted to ensure the following levels of HIPAA compliance: Level 1 – Syntactical integrity: Testing of 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 →

837 Dental Transaction Mapping

837 Dental Transaction Mapping Exercise Example 837 Dental Transaction Mapping exercise gives a scenario of working with a 837 Dental Transaction file to complete the claim and send it to processing. 837 Dental Transaction Mapping exercise will be useful for insurance companies, providers and HIPAA specialists. Scenario: Patient MINI DUCK dependent son of DONALD DUCK goes to the 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 →

EDI Procedure

EDI Procedure FAQs For Health Partners Plans Vendors EDI Procedure frequently asked questions and answers given below will help Health Partners Plans partnering parties to overcome difficulties during claims processing. EDI Procedure notes should be taken into account before sending electronic claims to Health Partners Plans. What information do I need to submit my claims electronically to Read More →