Medicare EDI Support Program Medicare EDI Support is released by A/B Medicare Administrative Contractors (MACs) and Durable Medical Equipment (DME) MACs as well as the DME MAC Common Electronic Data Interchange (CEDI) contractor. Medicare EDI Support is provided for physicians, suppliers and other providers that submit claims and conduct other Health Insurance Portability and Accountability Act … Read More →
Medicare EDI Basics For Providers, Clearinghouses And Agents Medicare EDI systems contain extensive Personally Identifiable Information (PII) on beneficiaries. As established by the Privacy Act and the Health Insurance Portability and Accountability Act (HIPAA), beneficiaries have a right to expect that their data will not be seen by individuals or entities that do not have … Read More →
EDI Mapping Guides For WPS Health Solutions: Control Segments / Envelopes EDI Mapping Guides require that Interchange Control (ISA/IEA), Function Group (GS/GE), and Transaction (ST/SE) envelopes must be used as described in the national implementation guides. Medicare’s expectations for inbound ISAs and a description of data on outbound ISAs are detailed in this EDI Mapping Guides post. … Read More →
EDI Security Protocols (WPS Health Solutions EDI Communication) EDI Security Protocols policy strictly prohibits any trading partner from outsourcing system functions to any resource located outside of the United States or its territories. Prohibited outsourced functions include but are not limited to the transmission of electronic claims, receipt of remittance advice, or any system access … Read More →