Change Healthcare CLAIMS Provider Information Form *This form is to ensure accuracy in updating the appropriate account
|
|
- Randolph French
- 6 years ago
- Views:
Transcription
1 PAYER ID: SUBMITTER ID: 1 Provider Organization Practice/ Facility Name Change Healthcare CLAIMS Provider Information Form *This form is to ensure accuracy in updating the appropriate account Provider Name Tax ID Client ID Site ID Address City STATE ZIP Contact Name Address Telephone Fax 2 Vendor (Change Healthcare certified vendor used to submit files to Change Healthcare) Vendor Name Vendor Submitter ID Contact Name Address 3 Payer Payer ID Group ID Individual Provider ID NPI ID 4 Confirmations Send Change Healthcare Claim Confirmations To: Special Instructions: All Payer Registration forms must contain signatures when applicable, stamped signatures or photo copies are accepted. SUBMIT COMPLETED FORM TO: Fax: (615) batchenrollment@changehealthcare.com Testing may or may not be required for this payer, upon approval the payer will communicate to you directly, whether they will require test files from you on your first submissions. in the event you are required to send test files please be sure to send the required files to Change Healthcare as production claims and contact our claims support help desk once completed, so that we may be able to communicate to the payer the file name for your submission CHANGE HEALTHCARE REVISION FORM DATE:
2 Subject: LOB: Payer(s): ENROLLMENT - Alert Institutional/Professional SX140 - CA - PARTNERSHIP HEALTHPLAN 12M81 - CA - PARTNERSHIP HEALTH PLAN Topic: ** IMPORTANT REMINDER ** Be advised that Partnership Healthplan of California requires an EDI Enrollment Agreement to be completed by any 'NEW' Provider desiring to do EDI claims business with them. In addition, the payer also requires claim testing before any EDI transactions are accepted into Production. NOTE - If you are already in production and actively doing EDI claims business with Partnership Healthplan of CA, and then you may disregard this notice. Action Required by Customer: 1) All 'NEW' Providers desiring to do EDI claims business with the payer must complete and return to Emdeon for processing an EDI Enrollment Agreement. The EDI Enrollment Agreements can be found here: Institutional - Professional - SUBMIT COMPLETED FORM TO- Fax: (615) batchenrollment@emdeon.com 2) Your first claim file of at least 10 claims per National Provider ID must be submitted in production for testing purposes at Partnership Healthplan of CA. After submitting these claims, alert Emdeon of the submission by opening a service request through your normal support process. Emdeon will coordinate the testing with the Payer and notify the Provider when it is complete. This testing process can take approximately 2-3 weeks. Any production claim files received while still in the TEST process, will be rejected by the Payer. To confirm claim production status, please contact CA Partnership Health Plan at (707) Action Taken by Emdeon: Emdeon will receive, process, and transmit (to the Payer) your EDI Enrollment Agreement. The Payer will return the status of the EDI Enrollment Agreement and testing to Emdeon. Thank You for your attention and cooperation, Emdeon
3 Partnership HealthPlan of California 837 Claims Enrollment & Payer Agreement The 837 Claims Enrollment & Payer Agreement Document should be completed and signed by the Trading Partner and the Billing Provider. The Trading Partner is the party that submits electronic claims directly to Partnership HealthPlan of California (PHC). The Trading Partner and the Billing Provider representatives that sign the 837 Claims Enrollment & Payer Agreement Document indicate that the Trading Partner is authorized to submit claim transactions in HIPAA compliant ANSI X12 formats on behalf of the Billing Provider. Billing Provider should continue to submit paper claims until they receive notification that the Trading Partner has been approved to submit electronic claims to PHC on behalf of the Billing Provider listed in the 837 Claims Enrollment & Payer Agreement Document. Partnership HealthPlan of CA accepts electronic files in the HIPAA compliant 5010 version of ANSI X12837 file formats. The completed 837 Claims Enrollment & Payer Agreement Document should be faxed to or ed to: After the completed 837 Claims Enrollment & Payer Agreement Document is received, our EDI Team will process it and the Trading Partner regarding enrollment completion or testing requirements. New Trading Partners will be assigned a submitter ID and will be provided with connection details for EDI file transmissions. To enroll providers for 835 electronic remittance advice files, please complete the form titled 835 ERA Enrollment & Payer Agreement Document. Trading Partners should not submit electronic claims on behalf of the billing provider until they receive confirmation from PHC that enrollment is complete and that the Billing Provider s NPI number has been set up for electronic claims submission.
4 Partnership HealthPlan of California 837 Claims Enrollment & Payer Agreement EDI PAYER AGREEMENT This Electronic Data Interchange (EDI) Payer Service Agreement (the Agreement ) is entered into by and between Partnership HealthPlan of California, a California corporation, with a principal place of business at 4665 Business Center Drive, Fairfield, California (hereinafter, PHC ), and (hereinafter, Trading Partner ). The purpose of this Agreement is to memorialize in writing, the existing connection PHC has with the Trading Partner to submit and receive EDI transactions on behalf of the Provider named in this agreement. In accordance with the Health Insurance Portability and Accountability Act (HIPAA) of 1996, PHC must have Business Associate Agreements in place to assure compliance with the rules and regulations dictated by it. Trading Partner s Full Legal Name: TRADING PARTNER S (SUBMITTER) INFORMATION Trading Partner s Principal Business Address: Trading Partner s Mailing Address (if different from principal business address above): Trading Partner s Tax ID #: Trading Partner s Contact Person: Trading Partner s State of Incorporation: Trading Partner s Telephone Number: Trading Partner s Address: Trading Partner s Fax Number: The Submitter ID is assigned by PHC. Leave blank if Submitter ID has not been assigned by PHC. Submitter ID Number: Approved Trading Partners must submit their Submitter ID in the GS02 element of inbound HIPAA compliant transactions sent to PHC. BILLING PROVIDER S INFORMATION Billing Provider s Name: Billing Provider s Contact Person: Billing Provider s Telephone Number: Billing Provider s Pay-To NPI Number: Billing Provider s Address: Billing Provider s Fax Number: Billing Provider s Physical Address: Page 1 of 2
5
MEDICAID DISTRICT OF COLUMBIA (77033) ERA ENROLLMENT INSTRUCTIONS
MEDICAID DISTRICT OF COLUMBIA (77033) ERA ENROLLMENT INSTRUCTIONS WHAT FORM(S) SHOULD I DO? Electronic Remittance Advice (ERA) Authorization Agreement WHERE SHOULD I SEND THE FORM(S)? Fax to: (202) 906-8399
More informationSECTION 3: TMHP ELECTRONIC DATA INTERCHANGE (EDI)
TEXAS MEDICAID PROVIDER PROCEDURES MANUAL: VOL. 1 SECTION 3: TMHP ELECTRONIC DATA INTERCHANGE (EDI) 3.1 TMHP EDI Overview.............................................................. 3-2 3.1.1 Advantages
More informationSECTION 3: TMHP ELECTRONIC DATA INTERCHANGE (EDI) TEXAS MEDICAID PROVIDER PROCEDURES MANUAL: VOL. 1
SECTION 3: TMHP ELECTRONIC DATA INTERCHANGE (EDI) TEXAS MEDICAID PROVIDER PROCEDURES MANUAL: VOL. 1 DECEMBER 2016 TEXAS MEDICAID PROVIDER PROCEDURES MANUAL: VOL. 1 DECEMBER 2016 SECTION 3: TMHP ELECTRONIC
More informationSECTION 3: TMHP ELECTRONIC DATA INTERCHANGE (EDI) TEXAS MEDICAID PROVIDER PROCEDURES MANUAL: VOL. 1
SECTION 3: TMHP ELECTRONIC DATA INTERCHANGE (EDI) TEXAS MEDICAID PROVIDER PROCEDURES MANUAL: VOL. 1 NOVEMBER 2018 TEXAS MEDICAID PROVIDER PROCEDURES MANUAL: VOL. 1 NOVEMBER 2018 SECTION 3: TMHP ELECTRONIC
More informationEDI Solutions Your guide to getting started -- and ensuring smooth transactions anthem.com/edi
EDI Solutions Your guide to getting started -- and ensuring smooth transactions anthem.com/edi 00175CAPEN (12/11) This brochure is a helpful EDI reference for both new and experienced electronic submitters.
More informationAppendix. CTMHP EDI General Information
Appendix CTMHP EDI General Information C C.1 Medicaid Billing Features............................................. C-2 C.2 Accessing the EDI Gateway............................................ C-2 C.3
More informationEDI Solutions Your guide to getting started -- and ensuring smooth transactions anthem.com/edi
EDI Solutions Your guide to getting started -- and ensuring smooth transactions anthem.com/edi 00175LNPEN (04/12) This brochure is a helpful EDI reference for both new and experienced electronic submitters.
More informationTMHP ELECTRONIC DATA INTERCHANGE (EDI) CSHCN SERVICES PROGRAM PROVIDER MANUAL
TMHP ELECTRONIC DATA INTERCHANGE (EDI) CSHCN SERVICES PROGRAM PROVIDER MANUAL MARCH 2018 CSHCN PROVIDER PROCEDURES MANUAL MARCH 2018 TMHP ELECTRONIC DATA INTERCHANGE (EDI) Table of Contents 41.1 TMHP EDI
More informationEDI Enrollment Webinar for Practice Insight Authorized Resellers
EDI Enrollment Webinar for Practice Insight Authorized Resellers Martha Johnson, Payer Development Andrea Frost, Project Manager Donna Anderson, Enrollment Specialist Outline Getting Started Where do I
More informationTMHP Electronic Data Interchange (EDI)
TMHP Electronic Data Interchange (EDI) Chapter.1 TMHP EDI Overview............................................................. -2.2 Advantages of Electronic Services...............................................
More informationTMHP Electronic Data Interchange (EDI)
TMHP Electronic Data Interchange (EDI) Chapter.1 TMHP EDI Overview............................................................. -2.2 Advantages of Electronic Services...............................................
More informationNomination Excellence in ehealth. CureConnect
Nomination Excellence in ehealth CureConnect CureConnect CureConnect provides an Electronic Data Interchange platform to keep medical practices in control and enjoy a whole new level of claim intelligence
More informationEssence. EDI Connectivity for. Institutional Claims
Essence EDI Connectivity for Institutional Claims Revised: December 15, 2011 Essence EDI Connectivity for Institutional Claims Table of Contents CHAPTER 1: INTRODUCTION TO THE SSI GROUP, INC.... 3 SETTING
More informationNew York State Society for Clinical Social Work
Introduction to Electronic Billing New York State Society for Clinical Social Work October 15, 2011 Today s Presenters Jim Bavoso Provider Outreach & Education Agenda Introduction & Welcome Background
More informationConnecticut interchange MMIS
Connecticut interchange MMIS Provider Manual EDI Options Chapter 6 Connecticut Department of Social Services (DSS) 55 Farmington Avenue Hartford, CT 06105 Hewlett Packard Enterprise 195 Scott Swamp Road
More informationNew Hampshire Developmental Services System. EDS Trading Partner Agreements for NH Medicaid Billing
New Hampshire Developmental Services System IT Task Force INTAKE, SERVICE CAPTURE AND BILLING SYSTEMS DEVELOPMENT PROJECT Operational Advisory #10 31 July 2003 EDS Trading Partner Agreements for NH Medicaid
More informationIntegraNet Claims 5010 Submission Companion Guide for 837 Professional and 837 Institutional Claims
VERSION 005010 IntegraNet Claims 5010 Submission Companion Guide for 837 Professional and 837 Institutional Claims This companion guide for the ANSI ASC X12N 837 Professional and Institutional Claim transaction
More informationEmdeon Frequently Asked Questions about. Operating Rules for ASC X12N Transactions for Dental Provider Services. October 2013
Emdeon Frequently Asked Questions about Operating Rules for ASC X12N Transactions for Dental Provider Services October 2013 Preface This information is provided by Emdeon for education and awareness use
More informationProvider Workshop Training
Provider Workshop Training 2017 1 TODAY S AGENDA Passport Provider Portal (New!) Claims System (NEW PAYER ID)! ERA/ InstaMed (NEW!) Packet Information Title VI Fraud, Waste and Abuse FAQs Quick Reference
More informationChapter 5 Claims Submission Unit 1: Benefits of Electronic Communication
Chapter 5 Claims Submission Unit 1: Benefits of Electronic Communication In This Unit Topic See Page Unit 1: Benefits of Electronic Communication Electronic Connections 2 Electronic Claim Submission Benefits
More informationElectronic Payments & Statements (EPS) Frequently Asked Questions (FAQs)
Electronic Payments & Statements (EPS) Frequently Asked Questions (FAQs) Note: EPS features contained within these FAQs may not be applicable to all Payers. General Questions 1. What is Electronic Payments
More informationIs Your Collection System Receiving the Right Dose of Automation? Presented to HFMA New Jersey and Philadelphia Metro Chapter 2011 Annual Institute
Is Your Collection System Receiving the Right Dose of Automation? Presented to HFMA New Jersey and Philadelphia Metro Chapter 2011 Annual Institute Payment Points in the Revenue Cycle A/R Creation Financial
More informationOFFICE ALLY 276/277 COMPANION GUIDE
Office Ally HIPAA Transaction 276\277 Standard Companion Guide Refers to the Implementation Guides Based on ASC X12 version 005010 CORE v5010 Master Companion Guide October 2014 2014 Office Ally Page 1
More informationAdministrative simplification is something we all desire and strive for in the healthcare industry.
PPO Network One Union Square 600 University Street, Suite 1400 Seattle, WA 98101 (800) 231-6935 www.fchn.com Fall 2012 - Provider Newsletter ADMINISTRATIVE SIMPLIFICATION PROVIDERSOURCE Administrative
More informationDentaQuest, LLC. 837 Dental Companion Guide
DentaQuest, LLC. 837 Dental Companion Guide T A B L E O F C O N T E N T S 1.0 Introduction 1.1 What is HIPAA?......3 1.2 Purpose of the Implementation Guide...3 1.3 How to Obtain Copies of the Implementation
More informationThe Tenth National HIPAA Summit Baltimore, Maryland. April 6-8, 2005
The Tenth National HIPAA Summit Baltimore, Maryland April 6-8, 2005 Streamlining New Jersey Hospital Inpatient/Outpatient Data Reporting Using EDI and HIPAA Standards Mark S. Gordon Senior Fellow/Director
More informationElectronic Payments & Statements (EPS)
Electronic Payments & Statements (EPS) What is EPS? Electronic Payments & Statements (EPS) Electronic Payments + Electronic Statements Electronic Funds Transfer (EFT): Direct Deposit Electronic Remittance
More informationNote: EPS features contained within these FAQs may not be applicable to all Payers.
Note: EPS features contained within these FAQs may not be applicable to all Payers. General Questi ons 1) Overall explanation of what Electronic Payments and Statements is? Electronic Payments and Statements
More informationProviderConnect Claims. March 2017
ProviderConnect Claims March 2017 Agenda ProviderConnect Advantages Claims Process Improvement How to Access ProviderConnect Direct Claim Submission Batch Claim Submission Claim Search Reprocessing a Claim
More informationTC 3 Health an Emdeon Company, ICD-10 Frequently Asked Questions. Published Q2 2014
TC 3 Health an Emdeon Company, ICD-10 Frequently Asked Questions Published Q2 2014 Preface This information is provided by TC 3 Health, an Emdeon Company for education and awareness use only. Even though
More informationPayer Affordable Care Act End-to-End Testing Checklist
Payer Affordable Care Act End-to-End Testing Checklist Overview The purpose of this checklist is to aid the payers that interact with providers, payers, and other trading partners in organizing end-to-end
More informationMassHealth. Health Care Claim Status Request and Response (276/277) Standard Companion Guide
MassHealth Health Care Claim Status Request and Response (276/277) Standard Companion Guide Refers to the Implementation Guides Based on ASC X12N version: 005010X212 Copyright 2014 MassHealth All rights
More informationlifebenefits Power of Attorney Notice
lifebenefits Power of Attorney Notice Many times throughout the past several years, BP employees and retirees who can no longer handle their own affairs - either through travel or disability - have sought
More informationOCREVUS Start Form. Instructions for Patients. Instructions for Health Care Providers
Instructions for Patients By completing this form: You will enroll in support services from Genentech You can apply to the Genentech Access to Care Foundation (GATCF) to determine if you are eligible to
More informationCardinal Innovations Healthcare
Cardinal Innovations Healthcare 837P Companion Guide Instructions Related to Transactions Based on ASC X12 Implementation Guide Version 005010X222A1 Health Care Claim: 837 Professional Companion Guide
More informationPhase IV Connectivity Best Practices for Success
Phase IV Connectivity Best Practices for Success July 17, 2018 2:00 3:00 PM ET Logistics Presentation Slides and How to Participate in Today s Session You can download the presentation slides at www.caqh.org/core/events
More informationAnalysis & Planning Guide for Implementing the Phase IV CAQH CORE Operating Rules
Analysis & Planning Guide for Implementing the Phase IV CAQH CORE Operating Rules December 2015 Table of Contents 1. Introduction: Analysis & Planning for Phase IV CAQH CORE Operating Rule Implementation...
More informationHow Plans and Providers Can Leverage Their HIPAA Investment for Productively and Profitability
How Plans and Providers Can Leverage Their HIPAA Investment for Productively and Profitability Walt Culbertson, Chair Southern HIPAA Administrative Regional Process (SHARP) 1 November 1, 2002 Opening Remarks
More informationStandard Companion Guide. ASC X12N 276/277: Health Care Claim Status Request and Response CORE Phase II System Companion Guide. Version Number: 1.
Standard Companion Guide ASC X12N 276/277: Health Care Claim Status Request and Response CORE Phase II System Companion Guide Version Number: 1.0 February 2012 Page 1 of 33 Page 2 of 33 Disclosure Statement
More informationStake your claim to better reimbursement.
NextGen Clearinghouse Stake your claim to better reimbursement. Get paid more, faster with automated, integrated solutions that improve results, provide better analytics, and offer powerful patient registration
More informationNCIC Claims Release 3.0 Implementation Schedule and Test Plan. NCIC Claims Release 3.0 Implementation Roll out Schedule... 2
Contents NCIC Claims Release 3.0 Implementation Roll out Schedule... 2 1. R3.0 Training (September 11, 2012)... 2 2. Trading Partner Registration (April 1 October 1, 2012)... 2 3. Trading Partner Testing
More informationNCPDP, HIPAA, SCRIPT and v5.1 Overview
NCPDP, HIPAA, SCRIPT and v5.1 Overview Renée Branson April 26, 2002 Who Is NCPDP? NCPDP is an ANSI-accredited standards development organization representing the pharmacy industry. We are a membership
More informationCollins and Aikman, Plastics and Cockpit Division Materials & Logistics Standard Operating Instruction
Collins and Aikman, Plastics and Cockpit Division Materials & Logistics Standard Operating Instruction PROCEDURE: 21 Author: IT Office DATE: 06/11/07 Approval: REVISION: 2 SUBJECT EDI GUIDELINES 1.0 PURPOSE:
More informationThe Electric ESP Handbook
The Electric ESP Handbook A GUIDE TO PACIFIC GAS &ELECTRIC COMPANY S DIRECT ACCESS PROCEDURES FOR ELECTRIC ENERGY SERVICE PROVIDERS Pacific Gas and Electric Company - ESP Services February 25, 2009 TABLE
More informationEFT Process Checklists
WEDI Strategic National Implementation Process (SNIP) WEDI SNIP Transactions Workgroup EFT Sub workgroup EFT Process Checklists Implementing a Healthcare Payment EFT Process Payer and Provider Checklists
More informationCHAPTER 2 ELECTRONIC DATA INTERCHANGE (EDI)
CHAPTER 2 ELECTRONIC DATA INTERCHANGE (EDI) TABLE OF CONTENTS HOW TO GET STARTED 2-2 REQUIRED EDI DOCUMENTS 2-2 VENDOR ACCURACY AUDIT PROGRAM 2-10 OUR STRATEGY ELECTRONIC DATA INTERCHANGE (EDI) In keeping
More informationCommunicating enrollment updates. Guide to your electronic options
Communicating enrollment updates Guide to your electronic options Your electronic options Whether you re a large, mid-sized, or small organization, you need an easy, effective way to communicate your enrollment
More informationAn Integrated Solution to Your Medical Billing & Collection Needs
An Integrated Solution to Your Medical Billing & Collection Needs 12708 Riata Vista Circle Suite A126 Austin, Texas 78727 Phone: (512) 637-2002 Fax: (512) 637-2007 www.ascend-health.com Second in importance
More informationThis section defines the requirements for shipping direct to store: An electronic (EDI 856) itemized list of goods to be shipped.
This section defines the requirements for shipping direct to store: Advanced Shipping Notice: Packing List: Routing: An electronic (EDI 856) itemized list of goods to be shipped. An itemized list of goods
More informationElectronic Billing for Intellectual and Developmental Disability Services
Electronic Billing for Intellectual and Developmental Disability Services Complete Revenue Cycle Management Solution Claim creation, submission of 837 electronic claims, handling denials, voids and replacements,
More informationOptum Intelligent EDI. Achieve higher first-pass payment rates and help your organization get paid quickly and accurately.
Optum Intelligent EDI Achieve higher first-pass payment rates and help your organization get paid quickly and accurately. The new benchmark for EDI performance Health care has outgrown commoditized EDI,
More informationFMG 810 Inbound Invoice Federated Merchandising Group ANSI X.12 Version 4010 ANSI X.12 Document Mapping FMG EDI 810
FMG EDI 810 The following is an outline of what is expected when receiving ANSI 810 Inbound Invoice information from a vendor for Domestic Private Label shipments (FMG). For definitions of the segments,
More informationThe New Medicare Card Project
The New Medicare Card Project ASK-THE-CONTRACTOR TELECONFERENCE (ACT) CGS ADMINISTRATORS, LLC. MEDICARE PART B November 30, 2017 Disclaimer This presentation was current at the time it was published or
More informationWorking with Aetna Electronically Tennessee Healthcare Financial Management Association Payer summit
Quality health plans & benefits Healthier living Financial well being Intelligent solutions Working with Aetna Electronically Tennessee Healthcare Financial Management Association Payer summit Nancy Yates
More informationlifebenefits Power of Attorney Notice
lifebenefits Power of Attorney Notice Many times throughout the past several years, BP employees and retirees who can no longer handle their own affairs - either through travel or disability - have sought
More informationHIPAA Summit VII. Preconference III. Advanced Strategies to Achieve ROI in Implementing HIPAA
HIPAA Summit VII Preconference III Advanced Strategies to Achieve ROI in Implementing HIPAA Case Study Report: The Health Reinsurance Association (HRA) and Pool Administrators Inc. (PAI) By Karl Ideman,
More informationImportant Information for Invoicing Hewlett Packard:
Important Information for Invoicing Hewlett Packard: Dear Supplier, Paper invoicing has always been an arduous and cost intensive process for both our Suppliers and HP. Invoices are often lost in transit
More informationDear Valued Supplier, Re: Shaw Industries Group, Inc. is phasing out paper invoices!
Dear Valued Supplier, Re: Shaw Industries Group, Inc. is phasing out paper invoices! Shaw Industries is very pleased to announce a progressive change in our accounts payable process that will ensure our
More informationEmdeon ICD-10 Program Playbook. Version 1.0 October 1, 2012 Version 1.1 Revised Q4 2013
Emdeon ICD-10 Program Playbook Version 1.0 October 1, 2012 Version 1.1 Revised Q4 2013 This information is provided by Emdeon for education and awareness use only. Even though Emdeon believes that all
More informationThe Basics of Healthcare EDI/EC
March 14, 2002 Jim Moynihan McLure-Moynihan Inc. Agoura Hills, CA www.mmiec.com The Basics of Healthcare EDI/EC HIPAA Summit West II HIPAA is all about Standards! Standards for automating the business
More informationIndiana Workers Compensation Board (IN WCB) Claims Release 3.1 Test Plan. Table of Contents
Table of Contents Indiana Summary... 2 Who is required to Test?... 2 Summary of Test Stages... 3 Miscellaneous Information for Test Stages... 3 Stage 1: EDI Trading Partner Profile Electronic Registration...
More informationIdaho Industrial Commission (IIC) EDI Claims Release 3.0 Test Plan Table of Contents
Table of Contents EDI Claims Release 3.0 Test Plan Overview... 2 Trading Partner Categories... 2 Who is required to Test?... 3 Summary of Test Stages... 4 Miscellaneous Information for Test Stages... 5
More informationEquiClaim, an Emdeon Company Audit and Recovery. ICD-10 Frequently Asked Questions. May 2014
EquiClaim, an Emdeon Company Audit and Recovery ICD-10 Frequently Asked Questions May 2014 Preface This information is provided by EquiClaim, an Emdeon Company, for education and awareness use only. Even
More informationHIPAA Implementation Strategies & Testing
HIPAA Implementation Strategies & Testing Washington, DC October 16, 2000 Gary Beatty President Washington Publishing Company Chair X12 Insurance Subcommittee gary@wpc-edi.com Health Insurance Portability
More informationAfter a valid PO is received from Party City/Party America, follow these procedures to ensure your invoices are paid on a timely basis:
Section 7a (Retail) Accounts Payable Overview Party City This section outlines important information for invoice requirements and processing policies. Accurate information will ensure timely processing
More informationOne Core Billing Solutions
One Core Billing Solutions Company Overview A Growing provider of healthcare solutions with over 10 years in the business. Focus on developing strategic partnerships and long-term relationships with our
More informationMay 17, 2011 SUBJECT: ADDENDUM NO. 3 REQUEST FOR PROPOSAL J12005 TO FURNISH ELECTRONIC MONITORING SERVICES FOR THE JUDICIARY, STATE OF HAWAII
May 17, 2011 MEMORANDUM TO WHOM IT MAY CONCERN FROM: Janell Kim Financial Services Administrator SUBJECT: ADDENDUM NO. 3 REQUEST FOR PROPOSAL J12005 TO FURNISH ELECTRONIC MONITORING SERVICES FOR THE JUDICIARY,
More informationAchieving Healthcare Interoperability in the Cloud with WebSphere ESB
Achieving Healthcare Interoperability in the Cloud with WebSphere ESB Ajay Asthana Business Solution Architect, Business Performance and Service Optimization Group IBM software division Tom Fausel Chief
More informationPromoting Administrative Simplification through. ERA and EFT Adoption: An Industry Call to Action
Promoting Administrative Simplification through ERA and EFT Adoption: An Industry Call to Action White Paper Contributing Authors: Tammy Banks, Optum Cloud Solutions Ana Croxton, Nextgen Pam Grosze, PNC
More informationCLINIC CONTROLLER MANAGE YOUR ENTIRE PRACTICE REPORTING REPORTING REPORTING COVER
CLINIC CONTROLLER EMR COVER SCHEDULING BILLING MANAGE YOUR ENTIRE PRACTICE WWW.A2CMEDICAL.COM We know how hard it is to choose an EMR / Practice Management System. This brochure provides only a brief overview
More informationElectronic Data Interchange User Guide for Nonemployer Group Trading Partners
Electronic Data Interchange User Guide for Nonemployer Group Trading Partners I. Getting Started Amerigroup District of Columbia, Inc. is a strong proponent of electronic data interchange (EDI) transactions
More informationOverview of Billing Guidelines for Early Intervention Services (EIS) and Targeted Case Management (TCM) Services for Children Ages 0 to 3
Overview of Billing Guidelines for Early Intervention Services (EIS) and Targeted Case Management (TCM) Services for Children Ages 0 to 3 EIS and TCM Services Implementation Sunshine Health is responsible
More informationWe accept both professional and institutional (a.k.a. facility) EDI claims.
Health Advantage (HA) EDI Claim Instructions For Providers Clearinghouses We receive EDI claims from Emdeon Envoy and Netwerkes clearinghouses. Since you may choose to contract with different clearinghouses
More informationApplication for Pro Bono Legal Assistance (Updated 5/4/2016) Part 1: Prospective Client Contact Information. 1. Organization: TODAY S DATE:
333 Faunce Corner RoadNorth Dartmouth, MA 02747Telephone: 508-985-1163Fax: 508-985-1136 (Updated 5/4/2016) Part 1: Prospective Client Contact Information 1. Organization: TODAY S DATE: Check this box if
More informationHIPAA Transactions & Code Set Standards Discussion of Final Rule and Next Steps
HIPAA Transactions & Code Set Standards Discussion of Final Rule and Next Steps Chris Wierz Vice President, Phoenix Health Systems 1 Agenda Intent of HIPAA Transactions and Code Sets Review of Final Rule
More informationI. Getting Started. INFORMATION E-Solutions CONTACT. EDI User Guide for non-employer group trading partners. Your Choice
EDI User Guide for non-employer group trading partners 5010 I. Getting Started Anthem is a strong proponent of EDI transactions because they significantly increase administrative savings and reduce operating
More informationJune My Insurance Manager. User Guide
June 2017 My Insurance Manager SM User Guide Table of Contents - Part 4 OFFICE MANAGEMENT FUNCTIONS.... 141 REMITTANCE INFORMATION... 141 EDI REPORTS... 144 EFT/ERA ENROLLMENT... 146 TROUBLESHOOTING TIPS
More information810 Inbound Invoice Federated Department Stores, Inc. (FDS) VICS Version 3060 VICS Document Mapping Effective 05/97
810 Inbound Invoice Federated Department Stores, Inc. (FDS) VICS Version 3060 VICS Document Mapping Effective 05/97 The following is an outline of what is expected when receiving VICS 810 Inbound Invoice
More informationBravely Addressing Disputed Claims
Bravely Addressing Disputed Claims 2014 Winter Institute & Annual Meeting Indiana Pressler Memorial Chapter of HFMA February 28, 2014 John Woerly, MSA, RHIA, CHAM, FHAM (317)590-3067 john.woerly@accenture.com
More informationANSI What providers need to know. ANSI 5010 What providers need to know
ANSI 5010 What providers need to know. 1 What does ANSI 5010 mean to your practice or facility? The new transaction set means there will be less ambiguity in the implementation guides. You will have one
More informationIntroduction to Provider Networks & Provider Applicant Process
Introduction to Provider Networks & Provider Applicant Process The University of Utah Health Plans (UUHP) contracts with physicians and other health care professionals and facilities to offer provider
More informationANZ EasyTransact QUICK GUIDE AUGUST 2015
ANZ EasyTransact QUICK GUIDE AUGUST 2015 Contents ANZ Easy Transact Quick Guide How can ANZ EasyTransact work for me? 3 How do I get started? 4 Register for ANZ EasyTransact 4 Adding new members 4 Creating
More informationIntroduction to Provider Networks & Provider Applicant Process
Introduction to Provider Networks & Provider Applicant Process The University of Utah Health Plans (UUHP) contracts with physicians and other health care professionals and facilities to offer provider
More informationImproving Claims Management. Flexible and User Friendly
Since 1989 Improving Claims Management Flexible and User Friendly Claims2Cash s easy-to-use web based interface allows any healthcare provider type to manage their entire billing process. Claims2Cash utilizes
More informationNew Hampshire Comprehensive
New Hampshire Comprehensive Healthcare Information System Annual Healthcare Claim Processors Meeting Date: Tuesday, July 22 th 2014 1:00pm 3:00pm EDT In-person (NH DHHS Brown Building Room 468) and WebEx
More informationOverview of Billing Guidelines for Early Intervention Services (EIS) and Targeted Case Management (TCM) Services for Children Ages 0 to 3
Overview of Billing Guidelines for Early Intervention Services (EIS) and Targeted Case Management (TCM) Services for Children Ages 0 to 3 November 30, 2018 EIS and TCM Services Implementation Sunshine
More informationHealthcare Payment & Remittance Medical Banking - Best Practices. Art Conklin, Director of FirstProxy and Electronic Payment Services
Healthcare Payment & Remittance Medical Banking - Best Practices Art Conklin, Director of FirstProxy and Electronic Payment Services Electronic Healthcare Payment Session Objectives Overview of medical
More informationELECTRIC ESP HANDBOOK
ELECTRIC ESP HANDBOOK A GUIDE FOR ELECTRIC SERVICE PROVIDERS (ESPS) PROVIDING DIRECT ACCESS SERVICE TO NON-RESIDENTIAL CUSTOMERS IN PG&E S SERVICE TERRITORY Pacific Electric and Electric Company Third
More informationWhite Paper Testing Sub Workgroup Testing and Implementation From the Provider Perspective: Is Your Practice Truly Ready?
WEDI Strategic National Implementation Process (SNIP) 5010 Testing Sub Workgroup White Paper 5010 Testing and Implementation From the Provider Perspective: Is Your Practice Truly Ready? April 29, 2011
More informationPhase II CAQH CORE Certification Test Suite version March CAQH All rights reserved. 1
Phase II CAQH CORE Certification Test Suite version 2.1.0 March 2011 CAQH 2008-2011. All rights reserved. 1 PHASE II CORE CERTIFICATION TEST SUITE Revision History for Phase II CORE Certification Test
More informationPractice Management Software Solution
Practice Management Software Solution Toll Free: 800.759.1321 Fax: 888.232.6556 Email: info@medipro.com www.medipro.com You have challenges WE have answers If your practice is like most, it s a challenge
More informationEmdeon ICD-10 Program Playbook. Version 1.0 October 1, 2012 Version 1.3 Revised Q3 2014
Emdeon ICD-10 Program Playbook Version 1.0 October 1, 2012 Version 1.3 Revised Q3 2014 This information is provided by Emdeon for education and awareness use only. Even though Emdeon believes that all
More informationImproving Claims Management. Flexible and User Friendly
Since 1989 Improving Claims Management Flexible and User Friendly Claims2Cash s easy-to-use web based interface allows any healthcare provider type to manage their entire billing process. Claims2Cash utilizes
More informationWorking with Anthem Subject Specific Webinar Series
Working with Anthem Subject Specific Webinar Series E-Tools for Providers Access audio conference: 877-497-8913 Conference code: 132-281-9809# Please Mute Your Phone Use the mute button or press *6 This
More informationHIPAA Testing--The Medicare Experience Centers for Medicare & Medicaid Services
HIPAA Testing--The Medicare Experience Centers for Medicare & Medicaid Services Kathy Simmons Technical Advisor OIS/Division of Data Interchange Standards Many Types of Medicare Testing 1. Alpha testing
More informationKareo Managed Billing Service
Kareo Managed Billing Service 2017-2018 This document is intended to outline what you can expect from Kareo, and what Kareo expects from you (at a detailed level) as part of the Kareo Managed Billing Service.
More informationAdministration overview
HRA Administration overview 2 Navia Benefit Solutions Navia Benefit Solutions, Inc. (Navia) was founded in 1990 by Jim and Stan Aitken. What began as a third-party administration firm for flexible spending
More informationImportant Information for Invoicing Hewlett Packard:
Hewlett-Packard Ireland Ltd Important Information for Invoicing Hewlett Packard: Dear Supplier, Paper invoicing has always been an arduous and cost intensive process for both our Suppliers and HP. Invoices
More informationPhase II CAQH CORE 250: Claim Status Rule version March 2011
Phase II CAQH CORE 250: Claim Status Rule Table of Contents 1 BACKGROUND SUMMARY... 3 2 ISSUE TO BE ADDRESSED AND BUSINESS REQUIREMENT JUSTIFICATION... 3 3 SCOPE... 4 3.1 What the Rule Applies To... 4
More informationProvider Perspective on the HIPAA/ACA Transactions, Code Sets, Identifiers and Operating Rules HIPAA Summit Mar. 18, 2015
Provider Perspective on the HIPAA/ACA Transactions, Code Sets, Identifiers and Operating Rules HIPAA Summit Mar. 18, 2015 Today s Agenda ICD-10 Current environment MGMA research Recent developments epayments
More information