Inbound Encounter Data File

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 files

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

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

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

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

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 →

HIPAA X12 EDI Training

HIPAA X12 EDI Training (Live Instructor-Led Webinars) by EDI Academy HIPAA X12 EDI Training has been customized for individual students and for groups of three or more from the same company. Become a certified professional after finishing the EDI Academy HIPAA X12 EDI Training on the best conditions. The cost is $250 per session per person for Read More →

EDI COB

EDI COB Center For Celerian Group Companies Customers, Beneficiaries And Providers EDI COB Center Assistance is given for CGS (Celerian Group Companies) contractors regarding EDI Coordination of Benefits issues. EDI COB Center Assistance (Benefits Coordination & Recovery Center) is provided to: All Customers Answers to general questions regarding Medicare Secondary Payer (MSP). Requests for duplicate questionnaires. Beneficiaries Read More →

EDI Coordination of Benefits

EDI Coordination of Benefits Basics For Celerian Group Company Medicare Contractors EDI Coordination of Benefits program purposes are to identify the health benefits available to a Medicare beneficiary and to coordinate the payment process to prevent mistaken payment of Medicare benefits. The BCRC (Benefits Coordination & Recovery Center) consolidates the activities that support the collection, management, and reporting Read More →