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 →
IEHP EDI SFTP (SECURE FILE TRANSFER PROTOCOL) Connection IEHP EDI SFTP (the Secure File Transfer Protocol) server is utilized to conduct all electronic data file transactions with contracted providers related to Member eligibility, encounter data, bedday reporting, capitation reports and electronic claims submissions. Some of the benefits to using the SFTP are: SFTP is a standard protocol … Read More →
EDI Test Purchase Orders (Using Test and Production Modes) – MedclickProclick Vendor Setup EDI Test Purchase Orders can be created and sent once you have EDI configured for your organization. Creating EDI Test Purchase Orders follows the same process as creating any other purchase order, with some additional recommendations about the purchase order number. On Figure below, … Read More →