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Electronic Data Interchange (EDI)
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- Alternative Options: If
you are not happy with your current practice management system (PMS) vendor, take
a look at some of your options for HIPAA compliance.
- ANSI ASC X12N 4010 Specifications: These documents are in portable
document format (PDF) and may be downloaded from this Web site.
 X12N User Guide (622 KB PDF)
- Billing Requirements:
Institutional (202 KB PDF)
Professional (222 KB PDF)
- CMS HIPAA Site:
This link will take you to the Centers for Medicare and Medicaid Services (CMS)
HIPAA site, where you will find information about deadlines, regulations and standards,
enforcement, upcoming events, educational material, the latest related news and
links to other HIPAA-related sites.
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CMS Online Presentations: This link will take you to a selection of
Centers for Medicare and Medicaid Services (CMS) informational presentations on
topics such as basic HIPAA knowledge, how to get paid, CMS enforcement, 837I and
837P, and HIPAA security.
- Compliance Statement: This
statement advises providers of the efforts of Arkansas Blue Cross and Blue Shield
to address the administrative simplification provisions of HIPAA.
- Contact EDI Services: This
section contains contact information.
- Electronic Claims Testing:
This information will help lead you through the process you must follow to become
approved for electronic claims submission in the new HIPAA-compliant format.
Asynchronous Communications Using Hyperterminal (349 KB PDF)
EDI Report User Guide (100 KB PDF)
- Electronic Data Interchange:
Private Business Transaction Companion Document (37 KB PDF) This document provides additional guidance concerning the segments/data elements necessary to successfully process HIPAA-compliant ANSI X12N version 4010A1 270/271, 276/277 and 278 transactions for private business members.
WPC-EDI.com This link will take you to the WPC electronic data interchange health care transactions site.
This site will contain the ANSI X12 Impementation guidelines that can be downloaded.
- EDI Forms: All forms must be signed and returned to EDI Services
via mail or fax. These forms are in portable document format (PDF) and allow you
to complete them online, print, sign and mail or fax to the appropriate address/fax
number.
Claim Status Enrollment (ANSI 276/277) (111 KB PDF)
Electronic Eligibility Enrollment Form (ANSI 270/271) (540 KB PDF)
Electronic Remittance Advice (ERA) (767 KB PDF)
Letter of Authorization (LOA) (14 KB PDF)
Miscellaneous-Transaction Enrollment Form (20 KB PDF)
Provider Enrollment Packet (100 KB PDF)
Submitter Information Update Form (28 KB PDF)
Trading Partner Agreement (TPA) (151 KB PDF)
- HIPAA Compliant Vendors List (28 KB PDF): A directory of electronic-billing vendors who have successfully tested with us and are in production for the Health Insurance Portability Accountability Act (HIPAA) version of the X12N 837 Health Care Claim.
- HIPAA Transaction and Code Sets Toolkit (2.1 MB PDF): Designed for physicians and other providers of professional health services, this toolkit is arranged in a series of brief chapters that address specific tasks to help you achieve HIPAA compliance.
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