270/271 Eligibility and Benefit Inquiry and Response Transaction Guidelines 270/271 Eligibility and Benefit Inquiry and Response guidelines describe recommendations for HMSA partners involved in electronic documents transmission. The main requirements include the following: If multiple payers or multiple HMSA contracts cover a patient, the 271 response will contain multiple EB segments (where EB01 = “R” … Read More →
Washington State Medicaid 270/271 HIPAA Transaction Notes Washington State Medicaid 270/271 HIPAA Transaction guidelines adopted under HIPAA clarify and specifiy the data content when exchanging electronically with Washington State Medicaid. When the trading partner submits the 270 request by any one of the specified methods the 270 request will be validated using EDI validator (up to … Read More →
Washington State Health Care Authority EDI And Enrollment Requirements Washington State Health Care Authority EDI program works under general HIPAA standard requirements. Health Insurance Portability and Accountability Act (HIPAA) Electronic Data Interchange (EDI) is an electronic method of communicating standard transactions between covered entities (providers, clearinghouses and health plans). HIPAA EDI allows covered entities to submit … Read More →
Matching 27x Request and Responses In Electronic Data Interchange Between HMSA And Its Partners Matching 27x Request and Responses recommendations are given to facilitate electronic documents transmission. The matching of a 27x request transaction with its response, it is recommended that a unique trace number be submitted in TRN02 at the patient level (Subscriber or Dependent loop) and, … Read More →