277CA edits

UnitedHealthcare 277CA edits for Medicare Advantage plans UnitedHealthcare applies edits when an electronically submitted claim is either missing key health care professional information or does not match the internal systems. These claims will be returned electronically on a 277CA (claims acknowledgement) clearinghouse rejection report with instructions on what to correct and subsequently resubmit the claim for Read More →

Resolving Errors 270/271

Tips for Resolving Errors with 270/271 Eligibility and Benefits Transactions (United Healthcare) UnitedHealthcare helps partners resolve errors to obtain member eligibility and benefits from 270/271 Health Care Eligibility and Benefit Inquiry and Response transactions. UnitedHealthcare current search logic allows entering different criteria related to the member or patient for the eligibility and benefits inquiry transaction (270). If Read More →

Healthcare Cost Savings

Healthcare Cost Savings Using Electronic Data Interchange CAQH, a nonprofit alliance, is the leader in creating shared initiatives to streamline the business of health care. The 2019 CAQH Index shows that the average cost to conduct transactions manually is higher than the cost of electronic transactions for care providers and health plans. Providers can use Read More →

HIPAA EDI Acronyms

HIPAA EDI Acronyms and Definitions Learn basic HIPAA EDI acronyms and definitions to understand the terminology used in health care CMS guidelines. EDI – Electronic Data Interchange – the process of using nationally established standards to exchange electronic information between business entities. HIPAA – Health Insurance Portability and Accountability Act of 1996 – legislation that mandated that Read More →

GS1 Standards

GS1 Standards in Use in Healthcare The widespread use of GS1 Standards has revolutionized efficiency, accuracy, and cost-effectiveness in a range of industries. Recognizing the impact that industry-wide adoption of a common language can have, GS1 Healthcare US® is committed to helping the industry improve efficiency and quality for lower costs, more streamlined care delivery, Read More →

HIPAA EDI Online

HIPAA EDI Online Webinars And Courses Description HIPAA EDI Online Webinars are suitable for novice and experienced specialists involved in Health Care and connected services. Training goes in a format of online instructor-led webinar. Attendees have the possibility to work on real-world examples and to ask the instructor EDI-related questions. Below, we give the description Read More →

GS1 Healthcare Standards

GS1 Healthcare Standards (Identification) The widespread use of GS1 Standards has revolutionized efficiency, accuracy, and cost-effectiveness in a range of industries. Recognizing the impact that industry-wide adoption of a common language can have, GS1 Healthcare US® is committed to helping the industry improve efficiency and quality for lower costs, more streamlined care delivery, and better Read More →

EDI Order-to-Cash Transactions

EDI Order-to-Cash Transactions in U.S. Healthcare Using GTINs and GLNs in EDI business messaging instead of proprietary identifiers can help improve transaction accuracy and efficiency, and more fully support traceability from the manufacturer to the patient / end user. GS1 guidelines describe key aspects of Order-to-Cash transactions in U.S. healthcare. 850 Purchase Order Used by the Read More →

Testing Service

GS1 US Rx EPCIS Certified Third-Party Conformance Testing Services Conformance testing under GS1 US Rx EPCIS Program will be conducted by third-party testing services certified by GS1 US (“certified conformance testing service”). Certified conformance testing services will be able to conduct conformance testing for all test scenarios. GS1 US will certify third-party testing services that satisfy Read More →

EDI training

GS1 Lightweight Messaging Standard Relationship To EPCIS Standard Lightweight Messaging standard is independent of GS1 Electronic Product Code Information Services (EPCIS) and does not require the use of EPCIS, although users are encouraged to implement EPCIS to capture their supply chain events and to leverage the EPCIS query interface to retrieve data to support their Read More →