AHCCCS EDI Transactions

AHCCCS EDI Transactions (Control Segments/Envelopes) AHCCCS EDI transactions transmitted during a session or as a batch are identified by an interchange header segment (ISA) and trailer segment (IEA) which forms the envelope enclosing the transmission. Each ISA marks the beginning of the transmission and provides sender and receiver identification.  Only one set of ISA/IEA is accepted by Read More →

AHCCCS EDI Transmission

AHCCCS EDI Transmission Administrative Procedures AHCCCS EDI transmission procedures require that each trading partner must establish an SFTP/EFT user account in order to exchange electronic data with AHCCCS. To setup an SFTP/EFT user account, the Electronic Data Exchange Request and External User Affirmation Statement forms must be completed for each individual user accessing SFTP/EFT. It is Read More →

AHCCCS EDI

AHCCCS EDI Testing Procedures AHCCCS EDI trading partners are responsible for ensuring that their transactions are compliant with HIPAA mandates based on the types of testing described below. AHCCCS encourages providers and other entities to use either a third party tool or AHCCCS’ Community Manager tool to certify that the entity can produce and accept HIPAA Read More →

EDI Medical Bills

EDI Medical Bills Acceptance And Rejection by Florida Division of Workers’ Compensation EDI Medical Bills may have the following statuses: Acceptance, Acceptance with Error, Rejection, Not Processed, Withdrawal, Correction, Replacement. When submitting corrections for rejections, replacements (amended/readjusted/data cleanup), or withdrawals, use the same Control Number that was used in the original submission of the medical bill. Submitted Read More →

Medical EDI

Medical EDI Implementation Guide (Electronic Medical Report Submission) Medical EDI is the electronic submission of medical bills by all healthcare providers. The Medical EDI Team assists electronic medical submitters with the management of electronic medical filings. To allow comparison benchmarking among the insurance industry, the team generates monthly report cards that denote the primary reasons for Read More →

837 Healthcare Claim

837 Healthcare Claim Implementation Guides 837 healthcare claim can be compared to an invoice in the merchandising world. However, it is much more complicated than that and some consider it to be the most complicated EDI transaction set. The purpose of this transaction is to submit healthcare billing information from providers of healthcare services to payers, either directly or Read More →

HIPAA EDI Online Webinars

HIPAA EDI Online Webinars And Courses Description HIPAA EDI Online Webinars are suitable for novice and experienced specialists involved in health care electronic operations. Training goes in a format of online instructor-led webinar. Attendees have the possibility to work on real-world examples and to ask the instructor HIPAA-related questions. Below we give the description of Read More →

HIPAA Claim Form

HIPAA Claim Form Requirements: Provider Signature on Claims HIPAA Claim Form CMS-1500, American Dental Association (ADA) Dental Claim Form, and 2017 Claim Form must be submitted with the provider’s or an authorized representative’s handwritten signature (or signature stamp) in the appropriate block of the claim form. Signatory supervision of the authorized representative is required. Providers delegating Read More →

Procedure Coding

HIPAA Claim: Procedure Coding (Texas Medicaid) Texas Medicaid uses the Healthcare Common Procedure Coding System (HCPCS) for HIPAA Claim submission. HCPCS provides health-care providers and third-party payers a common coding structure that uses codes designed around a five-character numeric or alphanumeric base. The procedure codes are updated annually and quarterly. HCPCS consists of two levels Read More →

Health Care Claim

Health Care Claim: Diagnosis Coding (Texas Medicaid) Health Care Claim must be coded by electronic billers. Health Care Claim is processed fast and accurately if providers furnish appropriate information. By coding EDI Health Care Claim, providers ensure precise and concise representation of the services provided and are assured reimbursement based on the correct code. If providers Read More →