AHCCCS EDI Test Data

AHCCCS EDI Test Data and Privacy Requirements EDI real-life production data enhances the overall value of the compliance testing process. If a covered entity elects to use production data in testing, it must ensure that it remains in compliance with all federal and state privacy regulations. Data (e.g., names and identification numbers) that would make Read More →

AHCCCS EDI

AHCCCS EDI Communication Start Basic Requirements AHCCCS (Arizona Health Care Cost Containment System) EDI Communication should start from agreeing all questions related to submission of electronic transactions and data with EDI Customer Support. Information required for initial inquiry Customer Name Organization Name Customer Email Address Customer Telephone Number Health Plan ID, Provider ID and/or NPI, Submitter Read More →

HIPAA EDI 835

HIPAA EDI 835 (Electronic Remittance Advice (ERA)) Mapping Test Do you feel comfortable with EDI 835 Electronic Remittance Advice (ERA)) Mapping? When someone sounds out EDI terms ISA, GS, ST, DTM, NM1, is it clear for you what this person means? We have prepared HIPAA EDI 835 Mapping Exercise  to check the level of your Health Care Read More →

EDI quiz

EDI 837 Institutional Quiz: Test your EDI knowledge Try an EDI 837 Institutional Quiz to check the level of your Health Care EDI knowledge. This practical exercise gives you a possibility to practice real-world example and find out gaps in your EDI knowledge. Patient Inpatient Face Sheet A young female Dora Max was a driver involved in a Read More →

HIPAA 837

HIPAA 837 Professional Quiz Scenario HIPAA 837 Professional Quiz will help to check you HIPAA EDI knowledge. Learn the following example: Patient Daisy Duck was referred to Dr. Ben Kildare by her doctor, Dr. Marcus Welby, MD. She saw Dr. Kildare, a skin specialist, on Nov. 16, 2015. She paid her co-pay of $10, at the Read More →

HIPAA EDI Quiz

HIPAA EDI Quiz: Test your EDI knowledge on practical examples Do you feel comfortable with terms like Submitter, Receiver, Billing Provider or Payer for the Claim? When someone sounds out EDI terms ISA, GS, ST, DTM, NM1, is it clear for you what this person means? Do you agree that Diagnosis Code numbers are not Read More →

AHCCCS EDI Transactions

AHCCCS EDI Transactions (Control Segments/Envelopes) AHCCCS EDI transactions transmitted during a session or as a batch are identified by an interchange header segment (ISA) and trailer segment (IEA) which forms the envelope enclosing the transmission. Each ISA marks the beginning of the transmission and provides sender and receiver identification.  Only one set of ISA/IEA is accepted by Read More →

AHCCCS EDI Transmission

AHCCCS EDI Transmission Administrative Procedures AHCCCS EDI transmission procedures require that each trading partner must establish an SFTP/EFT user account in order to exchange electronic data with AHCCCS. To setup an SFTP/EFT user account, the Electronic Data Exchange Request and External User Affirmation Statement forms must be completed for each individual user accessing SFTP/EFT. It is Read More →

AHCCCS EDI

AHCCCS EDI Testing Procedures AHCCCS EDI trading partners are responsible for ensuring that their transactions are compliant with HIPAA mandates based on the types of testing described below. AHCCCS encourages providers and other entities to use either a third party tool or AHCCCS’ Community Manager tool to certify that the entity can produce and accept HIPAA Read More →

EDI Medical Bills

EDI Medical Bills Acceptance And Rejection by Florida Division of Workers’ Compensation EDI Medical Bills may have the following statuses: Acceptance, Acceptance with Error, Rejection, Not Processed, Withdrawal, Correction, Replacement. When submitting corrections for rejections, replacements (amended/readjusted/data cleanup), or withdrawals, use the same Control Number that was used in the original submission of the medical bill. Submitted Read More →