TMHP EDI

TMHP EDI Overview and Advantage of Electronic Services (Texas Medicaid & Healthcare Partnership) TMHP EDI program and the Health and Human Services Commission (HHSC) encourage providers to submit claims and other requests electronically. Providers can participate in the most efficient and effective method of submitting requests to TMHP by submitting through the TMHP Electronic Data Interchange (EDI) Read More →

EDI COB

EDI COB Center For Celerian Group Companies Customers, Beneficiaries And Providers EDI COB Center Assistance is given for CGS (Celerian Group Companies) contractors regarding EDI Coordination of Benefits issues. EDI COB Center Assistance (Benefits Coordination & Recovery Center) is provided to: All Customers Answers to general questions regarding Medicare Secondary Payer (MSP). Requests for duplicate questionnaires. Beneficiaries Read More →

EDI Coordination of Benefits

EDI Coordination of Benefits Basics For Celerian Group Company Medicare Contractors EDI Coordination of Benefits program purposes are to identify the health benefits available to a Medicare beneficiary and to coordinate the payment process to prevent mistaken payment of Medicare benefits. The BCRC (Benefits Coordination & Recovery Center) consolidates the activities that support the collection, management, and reporting Read More →

ICD-10

ICD-10 Compliance FAQs (Security Health Plan) ICD-10 compliance means that a HIPAA-covered entity uses ICD-10 codes for health care services provided on or after October 1, 2015. ICD-9 diagnosis and inpatient procedure codes cannot be used for services provided on or after this date. The ICD-10 deadline has been delayed by the federal government until no earlier than  October Read More →

images

San Francisco Health Plan Claims Billing: Inpatient Services, Facility Outpatient, Medical Supply, Duplicate Billings San Francisco Health Plan Claims Billing Notes described below regard to some points not mentioned in the previous posts devoted to EDI requirements. Inpatient Services, Facility Outpatient, Medical Supply, Duplicate Billings notes are presented in general. Inpatient Services San Francisco Health Read More →

820

820 Payment Order / Remittance Advice (RA) definition and important notes The 820 Payment Order / Remittance Advice can be used in three ways: (1) It can be used as a remittance advice to describe detailed information about a payment. (2) It can be used to authorize financial institutions to electronically transfer funds (EFT) from Read More →

835 billing

835 billing scenarios examples 835 billing scenarios  describe what meaning and purpose can 835 transaction bring to the receiver. The 835 (similar to the 820) can be transmitted from the payer just as a remittance advice (and EOB explanation of benefits) letting the provider know what is being paid. It can also be transmitted as an Read More →