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 →