Office of Workers’ Compensation Programs EDI Basics
EDI allows Providers to avoid claim processing delays, reduction of administrative postage, materials and handling cost, faster detection of errors and faster payments. In the series of posts #WCMBP_EDI, we’ll cover information on how to establish an EDI account and submit files.
Providers can submit their EDI files through the Workers’ Compensation Medical Bill Process (WCMBP) System.
The WCMBP system supports the following EDI transactions:
- 837 Inbound File – An electronic file that contains information about a patient claim that are sent by healthcare providers to a payor (OWCP).
- 835 Outbound File – Is the electronic Remittance Voucher(RV)/Explanation of Benefits(EOB) sent by payor (OWCP) to providers about the healthcare services being paid/denied for.
- TA1 Outbound Acknowledgement – It reports the status of the processing of an interchange. This report confirms whether EDI successfully received the interchange or transmission. It notifies the Trading Partner of encountered errors after it verifies the envelop structure.
- 999 Outbound Acknowledgement – A response that a file was received properly.
In the next post, we’ll speak about how can EDI bills be submitted.
To learn more about HIPAA EDI and become a certified EDI Professional, please visit our course schedule page.