Ingham Health Plan EDI Claim Forms Guidelines Ingham Health Plan EDI Claims should be sent directly to Emdeon (Ingham Health Plan clearinghouse). In order to to participate in electronic claims submission partnership with Ingham Health Plan your party must be a customer of  Emdeon. Also your party can send Ingham Health Plan EDI Claims using the service of any Read More →

Ingham Health Plan EDI Claims Guidelines Ingham Health Plan EDI Claims (both professional and institutional) are excepted through Ingham Health Plan clearinghouse Emdeon. Ingham Health Plan uses Electronic Data Interchange (EDI) for electronic claims submission. Ingham Health Plan EDI Claims submission eliminates the need for your office staff to prepare claims manually or re-key repetitive transaction information. Read More →

Clean Claims

Clean Claims EDI Processing and Other Health Coverage Cases Clean Claims will be processed by San Francisco Health Plan as submitted in a timely manner for medically necessary and covered services by a participating provider group in accordance with the agreement between SFHP and the provider group for the applicable benefit program. Clean Claims are Read More →

San Francisco Health Plan EDI Claims: Common Requirements San Francisco Health Plan EDI Claims are processed for the following medical groups: San Francisco Community Clinic Consortium, San Francisco Health Network (previously known as the Community Health Network) and UCSF Medical Group. Any delegated medical group must submit encounter EDI data to San Francisco Health Plan Read More →

medical codes

Medical Codes Overview San Francisco Health Plan uses medical codes according to Medi-Cal billing guidelines in addition to Optum coding books application for claim activities. The following procedure medical codes must be used for a claim to be processed: Professional charges – HIPAA compliant HCPCS Level 1 (CPT) & level 2 Inpatient hospital/facility/institutional charges – Read More →

835 EDI Transaction

835 EDI Transaction Reconciliation process description 835 EDI Transaction is an important transaction type in electronic documents exchange. Today EDI speeds and simplifies many transactions. Then there’s the world of healthcare remittance advice. The systems, standards and processes currently in place at healthcare payers’ companies are so profoundly behind those of other industries. Depending on the provider, Read More →

Tufts Health Plan Claim

Tufts Health Plan claim options and useful notes Tufts Health Plan Claim EDI processing helps providers to submit claims electronically – either directly or through a clearinghouse – and receive electronic remittance from Tufts Health Plan. For quicker payment, fewer rejections and ease of processing, providers can send their Tufts Health Plan claim electronically using the following electronic claim options: Read More →