Online EDI Training | EDI Course Information

Detailed Course Content - EDI Fundamentals and Best Practices – Health Care

Information, Registration, and Fees:

- - Designed for HIPAA and Health Care EDI Transactions (e.g., 837,834,278,270-271,835,999, 276-277, 277RFAI-275)
  - These are live webinars. You can consult an expert who has implemented EDI for dozens of companies and trading partners.
  - Every attendee will become a Certified EDI Academy Professional by the EDI Academy if they complete all six webinars listed below.
  - You will receive a 100+ page course manual and other educational resources.
  - Previous attendees are pleased with our webinars. Check out our reviews.
  - Some courses have prerequisites.
  - The cost is $300 per session per person for each webinar (a la carte).
  - Pay $250 per webinar if you simultaneously sign up for all six webinars. Please email us at info@ediacademy.com to get the discount, or register here.
  - Group Discounts: If your company has three or more people willing to take all six webinars, there is a 40% discount. Your company will only pay $180 per webinar instead of $250 for each person. For example, three people taking all six webinars would get one invoice for $3,240. At least three people must take all six webinars to get this discount. Email us for an invoice and attendee details to info@ediacademy.com, and we will register you.
  - In-Person Training: Our instructor can fly out and conduct training at your office. Please email us for a proposal.

HIPAA EDI 101 - Introduction To The Health Care EDI Environment

Webinar Times: Mondays at 03:00 PM - 04:30 PM EST

2024 Dates: May 13th, June 3rd, July 22nd, August 19th, September 23rd, October 14th, November 11th, December 9th

- - Introduction to the Health Care EDI Environment, X12 Standards and X12 Workgroups and WEDI.
  - High-Level Overview of X12 HIPAA EDI Transactions:
    - 834 Benefit Enrollment
    - 270-271 Eligibility Inquiry/Response
    - 278 Prior Authorization/Referral
    - 837 Claims (Professional, Institutional, Dental)
    - 277 Claim Acknowledgment
    - 835 Health Care Claim Payment/Advice/EOB
  - EDI Components Overview: Mapper, Translator, Connectivity, ETL
  - EDI Connectivity (e.g., SFTP, HTTPS, Web Services)
  - Clearing Houses
  - EDI Team and Staffing Best Practices

HIPAA EDI 110 - EDI Enveloping & TR3 Viewing

Webinar Times: Tuesdays at 03:00 PM - 04:30 PM EST

2024 Dates: May 14th, June 4th, July 23rd, August 20th, September 24th, October 15th, November 12th, December 10th

- EDI Enveloping & TR3 Viewing
- EDI Enveloping ISA-GS-ST-SE
- Key terms related to the structure of EDI (e.g., qualifier, segment, terminator, delimiter)
- The Business Need for EDI
- Instructions on using the TR3 manual to look at transactions, segments and data elements, situational rules, and loops.
- LOOP IDs – Deep Dive (HL, NM1, CLM, etc.)
- Instructions on viewing EDI Implementation Guides and Mapping Specs
- Health Industry-Related Code Sets – Clinical and Non-Clinical

HIPAA EDI 201 – Deciphering HIPAA EDI Transactions – Enrollment & Eligibility

Note: HIPAA EDI 110 is a prerequisite for this class.

Webinar Times: Wednesdays at 03:00 PM - 04:30 PM EST

2024 Dates: January 10th, February 7th, March 13th, April 17th, May 15th, June 5th, July 24th, August 21st, September 25th, October 16th, November 13th, December 11th

- 834 Benefit Enrollment 005010X220A1
- 820 Premium Payment 005010X218
- 270-271 Eligibility Inquiry and Response & 271 005010X279A1
- CAQH Requirements – Real-Time & Batch

HIPAA EDI 210 – Deciphering EDI Transactions – 837 Claims

Note: HIPAA EDI 110 is a prerequisite

Webinar Times: Thursdays at 03:00 PM - 04:30 PM EST

2024 Dates: May 16th, June 6th, July 25th, August 22nd, September 26th, October 17th, November 14th, December 12th

- 837 Professional Claim 005010X222A1
- 837 Institutional Claim 005010X223A2
- 837 Dental Claim 005010X223A2

HIPAA EDI 215 – Deciphering EDI Transactions – 835 Health Care Claim Payment/Advice and Acknowledgements

Note: HIPAA EDI 110 is a prerequisite

Webinar Times: Fridays at 03:00 PM - 04:30 PM EST

2024 Dates: May 17th, June 7th, July 26th, August 23rd, September 27th, October 18th, November 15th, December 13th

- 277CA Claim Acknowledgment 005010X214
- 276-277 Claim Status Inquiry & Response 005010X212
- TA1 Acknowledgement
- 999 Acknowledgement 005010X231
- Medicare MAO Acknowledgments
- Deciphering 835 005010X221A1
- 835 Matching Logic
- Claim Adjustment Group Codes
- Claim Adjustment Reason Codes
- Line Level Balancing
- Claim Level Balancing
- Transaction Level Balancing
- Provider Level Adjustments

HIPAA EDI 401: Advanced 837 Coordination of Benefits. 277/RFAI & Encounters. SNIP Levels.

Note: HIPAA EDI 110, 210, and 210 are prerequisites for this class.

Webinar Times: Mondays at 03:00 PM - 04:30 PM EST

2024 Dates: May 20th, June 10th, July 29th, August 26th, September 30th, October 21st, November 18th, December 16th

- Part 1: SNIP Level Validation Rules 1-7. Critical knowledge for data validation.
- Part 2: COB In this session, we will cover advanced 837 topics with different situational rules. In addition, we will walk you through several scenarios of Coordination of Benefits and show you how the 837 and the 835 are linked when more than one payer is involved.
- Part 3: Transmitting 837 Outbound to CMS (Center for Medicare and Medicaid Services) is a common practice for most health plans. The Encounter Data System (EDS) Companion Guide contains information to assist Medicare Advantage Organizations (MAOs) and other entities in submitting encounter data. This class will review the highlights of the Encounter Companion Guide for institutional and professional claims. We will also highlight Medicaid claim companion guides for some states and show examples of 837 X12 transaction encounters.
- Part 4: 277/RFAI This combined section will cover the 277 Request for Additional Information and the 275 Health Care attachments.
- Part 5: 278 Prior Authorizations (Utilization Management) and Referral Authorizations