UHA Claim Submission

UHA Claim Submission (Trading Partner Guidelines) UHA Claim Submission specific instructions are required for electronic transfer of the claims data via Electronic Data Interchange processing systems. 997 Functional Acknowledgement UHA is required to create a 997 Functional Acknowledgement to report the results of the standard X12 syntax editing. The 997 will normally be available by the next business Read More →

UHA Claim Submission

UHA Claim Submission Requirements For Trading Partners UHA Claim Submission must be processed using the codes required in the National Implementation Guides and the HIPAA rules. Each transmission to UHA should have a unique Interchange Control Number (ISA13). UHA will use this number to determine if it is a duplicate file. b. Submitters are required to submit Read More →

Claims Testing

Claims Testing With UHA Trading Partners Claims testing is a necessary period after an agreement has been reached between the provider and UHA with regard to the submission of claims via EDI. The purpose of the testing is to ensure that the data being generated by the provider’s data processing system meets the technical requirements as specified in Read More →

Claims Processing

Claims Processing Cycle (UHA Providers) Claims Processing Cycle via EDI provides a quicker turnaround time on provider claims since it will eliminate the need for UHA to manually process the majority of the claims. However, the length of time required to process a claim depends on many variables in addition to the medium on which they are Read More →

Provider Claim Guidelines

Provider Claim Guidelines For UHA Trading Partner As of October 1, 2015, all HIPAA-covered entities are required to use ICD-10 codes for services on or after that date. UHA is committed to the timely and accurate processing of your claims, and encourage claim submission through electronic data interchange (EDI). There are three ways to submit medical Read More →

Filing A Healthcare Claim

Filing A Healthcare Claim Requirements For Cigna Vendors Filing A Healthcare Claim should be done as soon as possible. If you’re unable to file a claim right away, please make sure the claim is submitted accordingly. If you are a participating health care provider, submit by 90 days after the date of service If you are 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 →

EDI Claims

Cigna Electronic Data Interchange Claims Process Cigna Electronic Data Interchange vendors securely transmit data electronically to Cigna and gain many benefits of this process. Filing paper claims can be time consuming. When you submit claims to Cigna electronically, including coordination of benefits (COB) claims, your practice can gain many benefits such as: Quicker claims submission, including Dental Health Read More →

Electronic Medical Claims

Electronic Medical Claims Program Requirements (Manitoba Health, Healthy Living and Seniors) Electronic Medical Claims Program requires automation integrated with the current office tasks and procedures to maximize the benefits. An electronic medical billing system should provide your office with more rapid input, improved accuracy, faster processing and the ability to report and analyze practice statistics. Read More →

Provider Claim Guidelines

Operating Rules CAQH CORE 270: Connectivity Rule Guidelines Operating Rules CAQH CORE 270: Connectivity Rule requirements must be implemented by all entities seeking CORE Certification, including all other the CAQH CORE Eligibility and Claim Status Operating Rules. Operating Rules CAQH CORE 270: Connectivity Rule  state that the CAQH CORE 270 Rule is applicable only to the public Internet, which is a TCP/IP Read More →