medical codes

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 EDI Requirements

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 →

San Francisco Health Plan EDI

San Francisco Health Plan EDI Testing Process Overview San Francisco Health Plan EDI submitter setup must be completed before the submitter can send eligibility status transactions to the test San Francisco Health Plan EDI environment. San Francisco Health Plan notifies the provider after the successful completion of testing and prepares the provider for production status. During the Read More →