EDI overview

EDI Overview and Enrollment Procedures For Optima Health Providers EDI overview and requirements are to be used with the HIPAA-AS Implementation Guide. Each EDI vendor will have to sign a Trading Partner Agreement, which includes the Network Access Agreement and the Business Associate Agreement. EDI overview: Business Use Each transaction set will be used to expedite the execution of electronic Read More →

Medical Billing Software Vendor

How To Choose A Medical Billing Software Vendor For Submitting HIPAA Claims To Manitoba Health? Prior to selecting a medical billing software vendor the list of questions should be considered including requirements for the MHHLS billing applications. Installation: What is the waiting period for delivery and installation? Training: Is the training included in the purchase price? How Read More →

EDI Process Flow

EDI Process Flow At Veterans Health Administration (VHA) EDI Process Flow above flowchart represents the path that electronic claims follow at Veterans Health Administration (VHA). The objective of electronic billing is to submit completely correct claims. Claims sent electronically reach the payer faster, are processed faster, and are paid faster than claims submitted to the Read More →

Traceability In Healthcare

GS1 Healthcare Case Study: Improving patient safety through traceability initiative Sanatorio Güemes is a 522-bed private hospital in Buenos Aires, Argentina, that has established best practices regarding patient safety and quality of care. The hospital has implemented processes and policies to enable electronic medical records and improve inventory management, and are meeting many requirements of the National Read More →

GS1 Standards

Transformation with GS1 Standards: Franciscan Missionaries Case Study The Franciscan Missionaries of Our Lady Health System (FMOLHS) is a non-profit healthcare system serving more than half of Louisiana’s population. Challenged by the rising costs and growing complexity of delivering quality healthcare, FMOLHS needed to improve its operational efficiencies, control costs, and remain focused on what mattered most—the Read More →

Health Care EDI

Health Care EDI Real World Practice: HIPAA Compliance And Deviations Health Care EDI is one of the branches where Electronic Data Interchange accelerates information exchange, reduces manual interruption and provides processing reliability and security. Health Care EDI operates under the rules of HIPAA – standard that states requirements to health care electronic transactions. HIPAA concerns health care Read More →

GS1 Digital Link

GS1 Digital Link Barcoding: A Product’s Unique Identity GS1 Digital Link helps barcodes and other data carriers become web links – connecting a product’s unique identity to online sources of real-time information that brands control. The GS1 Digital Link standard extends the power and flexibility of GS1 identifiers by making them part of the web. This Read More →

EDI Claims Statusing

EDI Claims Statusing On The HAP Midwest Health Plan Website EDI Claims Statusing is provided for all HAP Midwest Health Plan providers.  EDI Claims Statusing can be tracked 24/7 on website at www.midwesthealthplan.com. Midwest Health Plan EDI Claims Statusing gives you the possibility to status up to three years of claims data. EDI Claims Statusing procedure Click on Read More →

Clean Claim Requirements

Clean Claim Requirements (Cigna vendors) Clean Claim Requirements were developed with the goal to process all claims at initial submission. Before Cigna can process a claim, it must be a “clean” or complete claim submission, which includes the following information, when applicable: primary carrier explanation of benefits (EOB) when Cigna is the secondary payer prescription for physical Read More →

Pharmaceutical EDI Data Integration

Pharmaceutical EDI Data Integration capabilities at McKesson Pharmaceutical EDI Data integration enables configurable pharmaceutical product and data sharing between pharmacy management systems, provider information systems and enterprise resource planning (ERP) systems. McKesson provides data interface solutions for pharmacy customers who are unable to support direct, automated electronic data interchange (EDI) through McKesson Data Exchange module. Solutions allow Read More →