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 →

EDI Billing

EDI Billing Notes: Do’s And Dont’s For Health Partners Plans Vendor Billing Operations EDI Billing guidelines given briefly in today’s post refer to general EDI billing rules set for Health Partners Plans partners. Health Partners Plans has identified the most common electronic errors that occur during EDI billing process and compiled a list of helpful hints that are Read More →

835 Electronic Remittance Advice

835 Electronic Remittance Advice: HIPAA EDI Companion Guides For Health Partner Plans Vendors 835 Electronic Remittance Advice notes explain the procedures and requirements necessary for Trading Partners of Health Partners Plans, Inc. to transmit the HIPAA standard transaction 835 Electronic Remittance Advice. 835 Electronic Remittance Advice General Notes An ANSI X12N 837 Health Care Claim is NOT required in Read More →

276/277 Health Care Claim Status Request

276/277 Health Care Claim Status Request and Response Companion Guides (Health Partners Plans) 276/277 Health Care Claim Status Request and Response transactions are included into Health Partners Plans EDI program. Electronic Data Interchange (EDI) customer service and technical assistance requests focus solely on the generation, processing, and/or transmission of a HIPAA standard transaction 276/277 Health Care Claim Read More →

HIPAA Standards

HIPAA Standards Basics: Privacy, Security, Transactions And Code Sets HIPAA Standards were set in 1996 when Congress passed the Health Insurance Portability and Accountability Act, otherwise known as HIPAA. HIPAA originally was conceived to improve fraud and abuse protections and provide protections for workers insured under group health plans when they leave their jobs and Read More →

EDI Health Partners: Basis Provider Requirements EDI Health Partners program requires all vendors use Electronic Data Interchange (EDI) – sending and receiving of information using computer technology. Any standard business document that one company would exchange with another; such as a purchase order, invoice, shipping schedule, inventory inquiry, and claim submission; can be exchanged via EDI between Read More →

EDI Connectivity

EDI Connectivity Notes For Unity Health Insurance Vendors EDI Connectivity guidelines will help parties involved in electronic documents exchange with Unity Health Insurance to get basic information about EDI process. EDI Connectivity Authentication/Authorization policies for User ID and Password (new trading partners) Sign and mail two original copies of trading partner agreement to Unity Health Insurance Once both originals Read More →

EDI Health Care Insurance Requirements For Unity Health Insurance Vendors EDI Health Care Insurance refers to Electronic Claims Submission. It allows medical providers and other parties involved in EDI Health Care Insurance to send and receive health care claims information. Unity supports all HIPAA-compliant electronic transactions. You can submit EDI Health Care Insurance claims to Unity one Read More →

997 Functional Acknowledgement

997 Functional Acknowledgement And Claim Audit Report For BCHP Vendors 997 Functional Acknowledgement is returned for each batch transaction received. This file acknowledges the receipt of the file and reports any data compliance issues. BUCKEYE COMMUNITY HEALTH PLAN also expects to receive a 997 Functional Acknowledgement transaction when the trading partner receives any outbound batch transaction. Read More →

Mapping Guides

Mapping Guides – ISA Segment Mapping Guides given below in the blog regard to ISA segment of the BUCKEYE COMMUNITY HEALTH PLAN 837P claim. Data files are transmitted in an electronic envelope. The communication envelope consists of an interchange envelope and functional groups. The interchange control structure is used for inbound and outbound files. An inbound interchange Read More →