Authorization EDI Data Submission Requirements (IEHP Providers) Authorization EDI Data policy applies to IPAs and other Entities that have been delegated medical management where IEHP retains financial risk or administrative processing for those services. IEHP contractually requires Independent Provider Associations (IPAs) to submit all authorization data to IEHP at a minimum frequency of once per business day and … Read More →
IEHP EDI Network Testing Basics And DHCS Duplicate Logic IEHP EDI Network Providers will be required to submit test files to ensure the submitter’s systems are properly configured for data submission. Before exchanging production transactions, each plan must complete testing to become certified. This process allows IEHP EDI Network to confirm that the DHCS operational guidance has been properly programmed … Read More →
837 Health Care Claim Technical Procedures And Infrastructure (IEHP Provider Network) 837 Health Care Claim: Professional Transaction must be transmitted by business partners to IEHP by connecting to the IEHP Network. They go from the Internet through a Virtual Private Network (VPN) tunnel to the IEHP Secure File Transfer Protocol (SFTP) Server. In standard software-to-hardware VPN connections, VPN client … Read More →
EDI Files Timeframe And Schedules For IEHP EDI Providers EDI Files processing schedules and timelines must be adhered to for IEHP COB plans. These schedules include: Eligibility Data File Transmission Schedule, Encounter Data File Due Date Schedule, Capitation Data File Transmission Schedule. Eligibility data files are placed on the Secure File Transfer Protocol (SFTP) server. A full monthly file is … Read More →