HIPAA 837 Transaction IEHP Business Scenarios (Examples) and Frequently Asked Questions HIPAA 837 Transaction IEHP Business Scenarios described will be useful for partners Submitting HIPAA 837 Transaction to IEHP. Example 1- IPA Submitting Institutional Encounter Data Encounter data must be submitted by IPAs for all covered services provided to assigned Capitated members. Covered services include PCP visits Read More →

IEHP EDI Functional Acknowledgement/Reports (837 Health Care Claim: Professional Transaction) IEHP EDI Functional Acknowledgement/Reports – TA1 – Interchange Acknowledgement – enables the receiver to notify the sender when there are problems with the interchange control structure. As the interchange envelope enters the EDFES, the EDI translator performs TA1 validation of the control segments/envelope. The sender will only receive a Read More →

837 Health Care Claim: Professional Transaction based on ASC X12 Technical Report Type 3 (TR3) 837 Health Care Claim: Professional Transaction may be transmitted any day of the week to IEHP from a customer’s business partner. The transaction provides data on Medicare Advantage / Part D data. Technical Infrastructure and Procedures Business partners transmitting 837 Health Care Read More →

EDI Online Webinars (Instructor-Led Courses) EDI Online Webinars by the EDI Academy – we invite you to join our All Industries and HIPAA Online Webinars. See EDI Online Webinars schedule for winter-spring 2019 below. https://ediacademy.com EDI 101 – Introduction To EDI  Webinar Times: 11:00 AM – 12:30 PM EST – 2019 Dates: Jan 14, 2019 — Mar 04, 2019 Read More →

Response Files Operational Procedures Response Files like 999 Functional Acknowledgement file will be generated within one business day. To verify if the file was accepted or rejected at this level, look for the IK5 and AK9 segments. If these two segments are followed by an ‘A’ the file was accepted. If these two segments are followed by an Read More →

HIPAA EDI Training 2019 Dates HIPAA EDI Training classes are taught by highly-qualified EDI professionals. All of them have at least 10 years of industry experience. January 31-February 1st, 2019 May 16-17, 2019 September 19-20, 2019 December 5-6, 2019 Classes typically run from 9:30 AM to 4:00 PM Registration Fee: Early – Bird $1,500. Late Read More →

File Transmission (Claims File Exchange Via SFTP Server) File Transmission by IEHP is released via a secure SFTP server for all claims file exchanges. Each direct submitter is assigned an account and a home directory on the SFTP. Within this home directory are several subfolders, each of which serves a specific purpose: sftp.iehp.org – [Home Directory] – 5010 – Read More →

SFTP Connection Testing (IEHP EDI Partners) SFTP Connection Testing may be started after the submitter ID and SFTP credentials have been created, and a new enrollee will work with the Service Delivery Team to test the connection to the SFTP server. Test files will be uploaded and downloaded to ensure no problems exist with the credentials before moving Read More →

EDI Enrollment With Inland Empire Health Plan (IEHP) EDI Enrollment will be a smooth process, if a completed enrollment form was submitted to the EDI department at IEHP, providing all information need to get started. This includes details about the enrollee, the primary and technical contacts, and the types of claims EDI transactions being requested, 837I/837P/835. If the enrollee will be Read More →