CMS Net Provider EDI (Children’s Medical Services Network Provider Electronic Data Interchange) CMS Net Provider EDI is a web-based tool that enables approved CCS and GHPP providers and Medi-Cal Managed Care Plans to electronically access the status of Requests for Services/Authorizations. Providers and plans have access to view service authorizations, have the ability to print service authorizations, denial … Read More →
SelectHealth EDI Claims Submission – Basic Transactions SelectHealth EDI Claims can be sent electronically through an Electronic Data Interchange (EDI) instead of submitting claims by mail. Claims submitted electronically are typically more accurate and allow to reimburse more quickly. EDI is more than just claims, however. Through EDI transactions, you can also receive remittance advice, eligibility, and … Read More →
ASC X12 Implementation Acknowledgement (999) (CAQH CORE Certification) ASC X12 Implementation Acknowledgement (999) must be always returned by CORE-certified organizations. The organization must successfully complete all of the required certification test scripts required by the Phase II CAQH CORE Certification Test Suite to become CORE-certified. The ASC X12 Implementation Acknowledgement (999) can be used only to acknowledge … Read More →
X12 Interchange Acknowledgement (250: Claim Status Infrastructure Rule) X12 Interchange Acknowledgement must be returned for real time X12 276 claim status inquiries if the functional group is rejected, or the X12 277 response, to be conformant with this rule. CAQH CORE Rules do not address usage of the X12 Interchange Acknowledgement TA1. To send real time acknowledgments … Read More →