HIPAA compliance

HIPAA Compliance – the right way to standardization in a health care industry HIPAA Compliance at Anthem started in January 2000. In that year Anthem created the HIPAA Program Office. It was done to oversee all of Anthem’s HIPAA compliance activities. Since then, multiple HIPAA rules have been passed, including rules related to standard transactions and Read More →

Anthem HIPAA

Anthem HIPAA  as a permanent component of Anthem’s health care strategy Anthem HIPAA  strategy is developed to deliver excellent service. The commitment includes compliance with and support of the HIPAA mandates. Anthem is committed to standardization and the minimization of “administrative hassles”. This is done for Anthem members, physicians and other health care professionals. Also Anthem HIPAA is Read More →

HIPAA EDI 837 Transaction

HIPAA EDI 837 Transaction Terminology HIPAA EDI 837 Transaction  is a key component in electronic health care documents transmission. This process improves efficiency in health care by establishing and constantly improving national standards for clearing houses, providers and health insurance plans. HIPAA EDI 837 Transaction  is one of the most used EDI transactions. If you somehow deal with EDI in health care Read More →

837 health care claim

Envelope Structure of 837 Health Care Claim EDI Transaction 837 Health Care Claim transaction example below will be used to explain EDI enveloping. This particular EDI file contains two 837 claims transmitted on 01/01/2012. 837 Health Care Claim Envelope ISA*00* *00* *12*8586755250 *01*807685339 *120101*0742*^*00501*000001899*0*P*: GS*HC*8586755250*807685339*20120101*0742*685*X*005010X222A1 ST*837*3701*005010X222A1 BHT*0019*00*004545*20120101*135420*CH NM1*41*2*AGILE BILLING SOLUTIONS*****46*1981 PER*IC*ANN GILLIS*TE*8185601000 NM1*40*2*ANTHEM BLUE CROSS*****46*47198 HL*1**20*1 PRV*BI*PXC*207Q00000X Read More →

UnitedHealthcare EDI

UnitedHealthcare EDI requirements for Claim Status Inquiry & Response Transactions UnitedHealthcare EDI 276 transaction (Health Care Claim Status Inquiry) is used to inquire about the status of a claim after it has been sent to a payer. UnitedHealthcare EDI 277 transaction (Health Care Claim Status Response) is used to respond to a request inquiry about the status of Read More →

UnitedHealthcare EDI

UnitedHealth Group EDI solution in health care industry partnership Using Electronic Data Interchange (EDI) to exchange information with UnitedHealth Group EDI department and other payers has many advantages. Take a look at the benefits and savings below to see how UnitedHealth Group EDI initiative may benefit your practice. Send and receive information faster. With UnitedHealth Group EDI, Read More →

Healthcare EDI

Basic definition of Healthcare EDI and its environment Electronic data interchange (EDI) is a business-to-business, computer-to-computer exchange of transaction information. The examples are: Health Care Claims, Payments, and Benefit Enrollment transactions. Each of these transaction types in Healthcare EDI has a specifically defined, computer-readable format assigned to it. This is referred to as a transaction Read More →

edi with rite aid

Rite Aid 835 EDI – Payment Remittance Advice Rite Aid 835 EDI is subjected to ‘Level 2’ or external testing as defined in the regulations on January 1, 2011 for the Health Insurance Portability and Accountability Act (HIPAA). A very good way to examine the Rite Aid 835 EDI is to think of it as an explanation Read More →