NCPDP SCRIPT Standard In The Health Care Industry NCPDP SCRIPT Standard was first published in 1997 and has been updated at least annually based on the business needs identified by the industry. SCRIPT is a standard created to facilitate the transfer of prescription data between pharmacies, prescribers, intermediaries, facilities, and payers. Within SCRIPT, basic business operations Read More →

EDI Worldwide Standards List And Description (Part 2) EDI worldwide standards appeared as business requirements were quite different and diverse, and organizations tried to optimize messaging formats. There are formats used across industries to facilitate business communication. We continue to describe international EDI standard formats. HIPAA (The Health Insurance Portability and Accountability Act). HIPAA EDI is a set of Read More →

EDI Online Webinars (Instructor-Led Courses) EDI Online Webinars by the EDI Academy – we invite you to join our All Industries and HIPAA Online Webinars. See EDI Online Webinars schedule for winter-spring 2019 below. https://ediacademy.com EDI 101 – Introduction To EDI  Webinar Times: 11:00 AM – 12:30 PM EST – 2019 Dates: Jan 14, 2019 — Mar 04, 2019 Read More →

HIPAA EDI Training 2019 Dates HIPAA EDI Training classes are taught by highly-qualified EDI professionals. All of them have at least 10 years of industry experience. January 31-February 1st, 2019 May 16-17, 2019 September 19-20, 2019 December 5-6, 2019 Classes typically run from 9:30 AM to 4:00 PM Registration Fee: Early – Bird $1,500. Late Read More →

IEHP EDI Outbound Response Files (Provider Connection) IEHP EDI Outbound Response Files (reports) are placed on the SFTP server in the Response_Prod folder in the Provider’s folder. An example of the file naming convention for the report describing the reasons the interchange control structure was not valid is 01s0318h101_40605_201604122150.TA1. A. 01s0318h101 identifies the original file name 1. (Reference the Read More →

Inbound Encounter Data File (IEHP Encounter Procedures) Inbound Encounter Data File must be submitted using SFTP. The files must be placed in the Encounter Folder within your Provider folder on the SFTP server. Inbound Encounter Data File Examples are given below. The naming convention for encounter data submissions consist of the following: A. All file names start with Read More →

Encounter Data File Due Date Schedule Encounter data file must be submitted to IEHP using SFTP. The files must be placed in the Encounter Folder within your Provider folder on the SFTP server. IEHP places all response reports on the SFTP server in the RESPONSE_PROD folder in the Provider’s folder, (Example: /01s/5010/Encounters/RESPONSE_PROD/). The files are placed in the Read More →

Encounter Data Processing Procedures (IEHP and Providers) Encounter Data processing and reporting is a shared obligation of IEHP and Providers. CMS/DHCS has mandated encounter data report formats and reporting timelines with which IEHP is required to comply. IEHP, in turn, contractually requires capitated Providers to provide encounter data based on IEHP’s regulatory obligations. IEHP has streamlined reporting requirements, Read More →

ELIGIBILITY PROCESSING PROCEDURES (IEHP EDI Partner Connection) Eligibility processing procedures are a key concern of all Providers in the IEHP network. IEHP receives Medi-Cal eligibility information from DHCS via an 834 file on a monthly basis. DHCS provides daily electronic eligibility files to update the Member files during the course of each month. For IEHP’s DualChoice CalMediConnect Plan (Medicare – Read More →