Medicare EDI Support

Medicare EDI Support Program Medicare EDI Support is released by A/B Medicare Administrative Contractors (MACs) and Durable Medical Equipment (DME) MACs as well as the DME MAC Common Electronic Data Interchange (CEDI) contractor. Medicare EDI Support is provided for physicians, suppliers and other providers that submit claims and conduct other Health Insurance Portability and Accountability Act Read More →

Medicare EDI

Medicare EDI  Basics For Providers, Clearinghouses And Agents Medicare EDI systems contain extensive Personally Identifiable Information (PII) on beneficiaries. As established by the Privacy Act and the Health Insurance Portability and Accountability Act (HIPAA), beneficiaries have a right to expect that their data will not be seen by individuals or entities that do not have Read More →

EDI mapping

EDI Mapping Guides For WPS Health Solutions: Control Segments / Envelopes EDI Mapping Guides require that Interchange Control (ISA/IEA), Function Group (GS/GE), and Transaction (ST/SE) envelopes must be used as described in the national implementation guides. Medicare’s expectations for inbound ISAs and a description of data on outbound ISAs are detailed in this EDI Mapping Guides post. Read More →

EDI Security Protocols

EDI Security Protocols (WPS Health Solutions EDI Communication) EDI Security Protocols policy strictly prohibits any trading partner from outsourcing system functions to any resource located outside of the United States or its territories. Prohibited outsourced functions include but are not limited to the transmission of electronic claims, receipt of remittance advice, or any system access Read More →

Slow Internet

EDI Communication Protocols (WPS Health Solutions) EDI Communication Protocols recommended for WPS Health Solutions EDI exchange are listed and described in today’s blog post. The implementation of WPS Community Manager provides new options for EDI Communication Protocols. WPS Gateway Express provides a secure web-based access for Trading Partners, so that the external users associated with these Read More →

EDI Connectivity

EDI Connectivity Requirements: Process Flows And Transmission Procedures (WPS Health Solutions) EDI Connectivity ensures the integrity of the electronic transaction process. EDI Connectivity and the Trading Partner Agreement are related to the electronic exchange of information, whether the agreement is an entity or a part of a larger agreement, between each party to the agreement. Trading Partners Read More →

EDI Testing

 EDI Testing Requirements (Trading Partners) EDI Testing – WPS Health Solutions follows CMS testing requirements. Main requirements are the following: 25 claim minimum ISA14 Strongly encourage to use a 1 or a TA1 will not generate ISA15 must = T for testing 100% Syntax 95% Medicare business rules Submitter is considered in test until approved Read More →

EDI Academy

EDI Academy 2017 Results and 2018 Plans EDI Academy is one of the leading USA companies providing Electronic Data Interchange education in the USA and Canada. The previous year has proved this again – it was quite successful for our team. 24 regular trainings where conducted and our students learned basics of EDI, its role Read More →

EDI Set-Up WPS

EDI Set-Up WPS Trading Partners (Using Third-Party Service) EDI Set-Up WPS Trading Partners requires Internet Aaccess for EDI Set-Up and electronic claims submission. If providers elect to submit/receive transactions electronically using a third party such as a billing agent, a clearinghouse or network services vendor, they are required to have an agreement signed by that Read More →

EDI Set-Up

EDI Set-Up For WPS Trading Partners EDI Set-Up for new direct submitters that will submit EDI claims directly to WPS state that they will need to complete a self-registration process on the WPS Community Manager System to prepare for 5010 testing and production claim submission. Internet Access is required for EDI Set-Up and electronic claims submission. As Read More →