EDI Claims

EDI Claims LifeWise Requirements And Guides EDI Claims for LifeWise are accepted in electronic form either by direct submission or from selected clearinghouses. Sending EDI Claims offers advantages: Less time spent on claims preparation Cost savings through prevention of loss and potential delay Detailed claim acceptance and rejection reporting Faster claims processing and response times A Read More →

EDI supply chain

EDI Supply Chain Most Frequently Used Electronic Documents EDI Supply Chain specialists involved in retail, purchasing, sales, warehousing or logistics inevitably come across EDI Supply Chain Transactions – standard format for exchanging business data electronically. EDI documents were created in order to exchange business data independently using modern software technologies. This process of data exchange Read More →

Third Party Logistics ED

Third Party Logistics EDI Documents Used In Electronic Business Relationships Third Party Logistics EDI Documents, as well as EDI documents used in other industries, were separated by ANSI X12 according market verticals for use in that specific industry or vertical. For the Warehousing and Third Party Logistics EDI, the 900 series of documents is the most common transaction Read More →

837 EDI structure

837 EDI Professional Claim (Anthem) Structure Descriptions 837 EDI Professional Claim Structure guidelines given below refer to the 837 EDI Professional Claim used in electronic data interchange by Anthem and its business partners taking part in the process of claims exchange. To avoid mistakes during 837 EDI Professional Claim preparation and electronic submission partners should carefully study technical Read More →

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837 Coordination of Benefits Requirements For Anthem Partners 837 Coordination of Benefits procedure described in the blog refer to the 837 Health Care Claim transaction requirements. The 837 Coordination of Benefits data elements work together to coordinate benefits between the East Region and Medicare or other carriers.  The East Region recognizes submission of an 837 transaction to Read More →

837 Professional Health Care Claim

837 Professional Health Care Claim Basic Technical Instructions For Anthem Partners 837 Professional Health Care Claim section provides information to help Anthem partners prepare for the ANSI ASC X12N 837 Professional Health Care Claim transaction. The information given in the blog must be used in conjunction with both the Transaction Set Implementation Guide “Health Care Claim: Professional, Read More →

Healthcare EDI Transactions

Healthcare EDI Transactions Real World Difference HIPAA The Health Insurance Portability and Accountability Act (HIPAA) was enacted by the U.S. Congress in 1996 as President Clinton responded to the need for more efficient healthcare services at lower costs. The solution was signing into law the Kennedy-Kassebaum Act. This act is also known as Health Insurance Read More →

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837 Health Care Claim Reports And Considerations Notes (Beacon Health Options) 837 Health Care Claim Reports And Considerations Notes for Beacon Health Options company partners are given below as mandated by the administrative simplification provisions of HIPAA. All 837 Health Care Claim reports will be available to providers/trading partners via the EDI Gateway in the respective mailboxes. To Read More →

837P and 837I Health Care Claims

837P and 837I Health Care Claims Notes For Beacon Health Options Partnering Parties 837P and 837I Health Care Claims are accepted by Beacon Health Options (Beacon) as mandated by the administrative simplification provisions of HIPAA. 837P and 837I Health Care Claims guidelines provided below areused in conjunction with the X12 implementation guide. The implementation guides for all HIPAA Read More →

HAP Midwest Health Plan’s Claims

HAP Midwest Health Plan’s Claims And Electronic Data Interchange Program HAP Midwest Health Plan’s Claims Department endeavors to assure prompt and accurate claim and encounter review, processing, adjudication and payment. This is accomplished through the development of claims processing systems, pre-payment and post-payment audits, policies, and procedures that are consistently and appropriately applied. HAP Midwest Read More →