Medical Codes Overview San Francisco Health Plan uses medical codes according to Medi-Cal billing guidelines in addition to Optum coding books application for claim activities. The following procedure medical codes must be used for a claim to be processed: Professional charges – HIPAA compliant HCPCS Level 1 (CPT) & level 2 Inpatient hospital/facility/institutional charges – … Read More →
San Francisco Health Plan 270, 271 EDI Transactions Examples San Francisco Health Plan 270, 271 EDI transactions are used in tandem: the 270 transaction is used to inquire about the eligibility benefit status of a subscriber, and the 271 transaction is returned in response to that inquiry. San Francisco Health Plan returns detailed eligibility, co-payment, … Read More →
San Francisco Health Plan EDI 276 and 277 Documents (Claim Status Request and Response) San Francisco Health Plan EDI 276 and 277 transactions are used in tandem: the 276 transaction is used to inquire about the current status of a specified claim or claims, and the 277 transaction in a response to that inquiry. San Francisco … Read More →
San Francisco Health Plan EDI Requirements: 270/271 Transactions Payer Specific Rules and Limitations San Francisco Health Plan EDI Requirements described below regard to all parties taking part in EDI process with San Francisco Health Plan. San Francisco Health Plan uses real time processing for its EDI transactions to provide immediate responses to its submitters. San … Read More →