EDI Claims Statusing

EDI Claims Statusing On The HAP Midwest Health Plan Website EDI Claims Statusing is provided for all HAP Midwest Health Plan providers.  EDI Claims Statusing can be tracked 24/7 on website at www.midwesthealthplan.com. Midwest Health Plan EDI Claims Statusing gives you the possibility to status up to three years of claims data. EDI Claims Statusing procedure Click on Read More →

HIPAA 837 Professional Claim

HIPAA 837 Professional Claim Mapping Guides For HAP Midwest Health Plan Partners HIPAA 837 Professional Claim transaction set is used to exchange institutional health care claim information from providers of health care services. HIPAA 837 Professional Claim can be submitted either directly or via intermediary billing services and/or claims clearinghouses. Please note that Professional and Institutional Read More →

EDI Claims

EDI Claims Post Payment Review (HAP Midwest Health Plan) EDI Claims post payment: HAP Midwest Health Plan conducts ongoing internal review of EDI Claims to determine completeness of claim, eligibility of member, benefit level for service, prior authorization as indicated, duplication of service and appropriate billing codes.  In cases where the services rendered appear to Read More →

Clean Claims

Clean Claims, Unclean Claims, Rejected Claims And Claims Resubmission (Midwest Health Plan) Clean Claims are claims that have all information in them and nothing is missing. If any mandatory or conditional information is missing, the claim will be considered unclean. Examples of unclean claims include invalid member ID, provider data discrepancy NPI and atax ID does not Read More →