EDI Claims Electronic Submission

EDI Claims Electronic Submission (Palmetto GBA Guidelines) EDI Claims Electronic Submission is released via telephone lines, via a modem, to Palmetto GBA. EDI Claims Electronic Submission gives the provider control over the timeliness and accuracy of the claims entry by eliminating the need for mailroom processing and manual data entry by Palmetto GBA. Payment for ‘clean Read More →

HIPAA Claims Filing

HIPAA Claims Filing Requirements For Palmetto GBA Providers HIPAA Claims Filing requirements by Palmetto GBA require providers to submit claims for all Medicare patients for services rendered. HIPAA Claims Filing requirements apply to all physicians and suppliers who provide covered services to Medicare beneficiaries. You may not charge your patients for preparing or filing a Medicare claim. The requirement Read More →

Electronic Claims Attachments

Electronic Claims Attachments: Supplemental Medical Documents Electronic Claims Attachments are supplemental documents providing additional medical information to the claims processor that cannot be accommodated within the claim format. Common attachments are Certificates of Medical Necessity (CMNs), discharge summaries and operative reports. They are sent to the Durable Medical Equipment Medicare Administrative Contractor (DME MAC) and/or A/B MAC with Read More →

Passport Health Plan EDI Guidelines And Recommendations Passport Health Plan EDI Program stimulates providers to submit claims electronically using Electronic Data Interchange instruments. Passport Health Plan EDI claims submitting 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. Read More →

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837 Health Care Claim Reports And Considerations Notes (Beacon Health Options) 837 Health Care Claim Reports And Considerations Notes for Beacon Health Options company partners are given below as mandated by the administrative simplification provisions of HIPAA. All 837 Health Care Claim reports will be available to providers/trading partners via the EDI Gateway in the respective mailboxes. To Read More →

HAP Midwest Health Plan’s Claims

HAP Midwest Health Plan’s Claims And Electronic Data Interchange Program HAP Midwest Health Plan’s Claims Department endeavors to assure prompt and accurate claim and encounter review, processing, adjudication and payment. This is accomplished through the development of claims processing systems, pre-payment and post-payment audits, policies, and procedures that are consistently and appropriately applied. HAP Midwest Read More →

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Affinity Health Plan EDI Claim Submission Requirements and Guidelines Affinity Health Plan EDI Claim information, unique to Affinity Health Plan claims, must be provided and properly formatted in the EDI file. The guidelines given in this blog and the previous one must be carefully studied by the partners before sending EDI claims to Affinity Health Plan.  Affinity Health Read More →