EDI For Medicare Fee For Services (FFS) Introduction And Requirements EDI For Medicare FFS is not limited to the submission and processing of claim related transactions, but includes processes such as provider EDI enrollment, beneficiary eligibility, coordination of benefits, as well as security and privacy concerns. So as not to be duplicative, where EDI is a relevant part … Read More →
Coordination of Benefits HIPAA Basics Coordination of Benefits requirements and basic procedure descriptions subject to the rules of the X12 837 HIPAA Technical Reports Type 3 (TR3s) as the national standard for provider electronic submission of health care claims to payers such as Medicare. It also contains the requirements for electronic transfer of claims from Medicare to … Read More →
Health Care Payment: Electronic Remit Advice and Standard Paper Remit Health Care Payment with Electronic Remit Advice (ERA) has a number of advantages over Standard Paper Remit (SPR). The amount payable for each line and/or claim as well as each adjustment applied to a line or claim can be automatically posted to accounting or billing applications from an … Read More →
Health Care Payment and Remittance Advice Health Care Payment information is reported within ERA (Electronic Remit Advice) or SPR (Standard Paper Remit). After Medicare processes a claim, either an Electronic Remit Advice or a Standard Paper Remit is sent with final claim adjudication and payment information. One Electronic Remit Advice or Standard Paper Remit usually … Read More →