HIPAA Standards

HIPAA Standards Basics: Privacy, Security, Transactions And Code Sets HIPAA Standards were set in 1996 when Congress passed the Health Insurance Portability and Accountability Act, otherwise known as HIPAA. HIPAA originally was conceived to improve fraud and abuse protections and provide protections for workers insured under group health plans when they leave their jobs and Read More →

EDI Health Partners: Basis Provider Requirements EDI Health Partners program requires all vendors use Electronic Data Interchange (EDI) – sending and receiving of information using computer technology. Any standard business document that one company would exchange with another; such as a purchase order, invoice, shipping schedule, inventory inquiry, and claim submission; can be exchanged via EDI between Read More →

EDI Connectivity

EDI Connectivity Notes For Unity Health Insurance Vendors EDI Connectivity guidelines will help parties involved in electronic documents exchange with Unity Health Insurance to get basic information about EDI process. EDI Connectivity Authentication/Authorization policies for User ID and Password (new trading partners) Sign and mail two original copies of trading partner agreement to Unity Health Insurance Once both originals Read More →

EDI Health Care Insurance Requirements For Unity Health Insurance Vendors EDI Health Care Insurance refers to Electronic Claims Submission. It allows medical providers and other parties involved in EDI Health Care Insurance to send and receive health care claims information. Unity supports all HIPAA-compliant electronic transactions. You can submit EDI Health Care Insurance claims to Unity one Read More →

997 Functional Acknowledgement

997 Functional Acknowledgement And Claim Audit Report For BCHP Vendors 997 Functional Acknowledgement is returned for each batch transaction received. This file acknowledges the receipt of the file and reports any data compliance issues. BUCKEYE COMMUNITY HEALTH PLAN also expects to receive a 997 Functional Acknowledgement transaction when the trading partner receives any outbound batch transaction. Read More →

Mapping Guides

Mapping Guides – ISA Segment Mapping Guides given below in the blog regard to ISA segment of the BUCKEYE COMMUNITY HEALTH PLAN 837P claim. Data files are transmitted in an electronic envelope. The communication envelope consists of an interchange envelope and functional groups. The interchange control structure is used for inbound and outbound files. An inbound interchange Read More →

EDI Files Submission

Claim Billing Information For BUCKEYE COMMUNITY HEALTH PLAN Partnering Parties Claim Billing information for BUCKEYE COMMUNITY HEALTH PLAN health care claims goes under HIPAA requirements. HIPAA specifies the electronic standards that must be followed when certain health care information is exchanged. These standards are published in National Electronic Data Interchange Transaction Set Implementation Guides. They are Read More →

837P Inbound Claim

837P Inbound Claim Guidelines For Providers And Clients 837P Inbound Claim notes by BUCKEYE COMMUNITY HEALTH PLAN serve as technical companion guides to assist application developers during the implementation process. The given information about 837P Inbound Claim is only intended to supplement the adopted IG’s and provide guidance and clarification as it applies to BUCKEYE COMMUNITY HEALTH PLAN. Read More →

EDI Technical Guides

EDI Technical Guides – Provider Basic Information EDI Technical Guides given in the blog refer to BUCKEYE COMMUNITY HEALTH PLAN partners in electronic transactions exchange. The following list includes basic technical information for each transaction: Lower case characters on inbound transactions are converted to uppercase on outbound transactions The following delimiters are used for all outbound transactions: Read More →

Electronic Transactions

Electronic Transactions As Part Of Buckeye Health Plan Partnership Program Electronic Transactions are used by Buckeye Health Plan to provide its participating providers with the best tools possible to support their administrative needs. Buckeye Health Plan electronic transactions capabilities will speed up the processing and payment of the health care claims. Electronic Transactions (EDI) support for HIPAA transactions is Read More →