Optum Intelligent EDI

Optum Intelligent EDI — no-cost claim submission to all payers Optum Intelligent EDI delivers the tools that help drive administrative simplification at minimal cost and realize the benefits originally intended by HIPAA — standard, low-cost claim transactions. Optum Intelligent EDI services include: Connections to over 4,000 payers Claims services – submission and remediation Remittances / ERAs Read More →

Ingenix Health Care EDI

Ingenix Health Care EDI Partner Integration Ingenix Health Care EDI solutions provide clients with effective and flexible solutions that health care providers are looking for—all from a single source. The Ingenix Vendor Partner Program provides: Simple x12 integration with client’s software, enabling customers to access to an industry-leading payer connectivity network n Integration with Ingenix’ EncoderPro.com®, the premier online Read More →

HIPAA Dental COB Claim

 HIPAA Dental COB Claim Mapping Exercise Example HIPAA Dental COB Claim example and exercise represent how to generate HIPAA Dental COB Claim file for processing by the destination payer. HIPAA Dental COB Claim Scenario Patient PUFFY DOG is seen a dentist DONALD D, DUCK in the office INFINITE ENDODONTICS. The payer of the HIPAA Dental COB Claim is Read More →

Healthcare-Billing-Outsourcing-Services

HIPAA 7030 271 Transaction: Detail Levels 3-4 HIPAA 7030 271 transaction is intended to meet the particular needs of the health care industry for the reporting of premium payment grace period information from a health plan to a provider. Find info about Header and Detail Levels 1-2 in the previous blog post. Detail Level 3 – Enrollee (2000C) Read More →

HIPAA 7030 271 Transaction

HIPAA 7030 271 Transaction Data Overview: Header, Detail Levels 1-2 HIPAA 7030 271 transaction is divided into five major areas – one header, and four detail hierarchical levels. Header The header area identifies the transaction type and implementation, as well as the transaction date and the business purpose of the specific transaction. ST03 identifies the Technical Report version Read More →

7030 271 Premium Payment Grace Period Notification

7030 271 Premium Payment Grace Period Notification: Compliance with Implementation Guide Requirements And State and Federal Regulations 7030 271 Premium Payment Grace Period Notification transaction complies with ASC X12 implementation guide requirements if the transaction satisfies all format and content rules and constraints specified in the applicable ASC X12 standards and the implementation guide (also known as a TR3) itself. Should Read More →

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Certification Test Program (Test Case Activities For CMS A/B MACs, CEDI and other contractors) Certification Test Program requires CMS trading partners to perform certification testing using the CTP and produce reports based on the test results. A test case describes each task that will insure ASC X12 data elements, qualifiers, and data values conform to the TR3 and the Read More →