EDI Forms & Guides

Electronic Data Interchange Services is your electronic way to submit information.

IBC has provided you with following links of guides and samples in order to enable you to use your EDI application with more ease and efficiency.

Claims Preprocessing Edits Claims Resolution

4010

• Claims Preprocessing Edits Claims Resolution Document (11/2010)

5010

• Claims Preprocessing Edits Claims Resolution Document (10/2011)

HIPAA Transaction Companion Guides*

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• Remittance Advice (835)
• Claim - Institutional (837-I)
• Claim - Professional (837-P)
• Incoming Transaction Envelope
• Outgoing Transaction Envelope

5010

• Remittance Advice (835)
• Claim - Institutional (837-I)
• Claim - Professional (837-P)
• Incoming Transaction Envelope
• Outgoing Transaction Envelope

Trading Partner Specification

4010

• U277 Trading Partner Specification (Claim Status Notification)

5010

• U277 Trading Partner Specification (Claim Status Notification)

Sample Transactions (file formats & data elements)

4010

• Remittance (835)
• Claim - Institutional (837)
• Claim - Professional (837)
• Claim Acknowledgement (997)
• Unsolicited Claim Status (U277)

5010

• Sample Transaction (834)
• Remittance (835)
• Claim - Institutional (837)
• Claim - Professional (837)
• Claim Acknowledgement (999)
• Unsolicited Claim Status (U277)

Payer ID List

• Professional Payer ID and Provider Number Reference
• Facility Payer ID and Provider Number Reference

Update on Regulations

• Centers for Medicare and Medicaid Services (CMS)
• BlueWeb
• Partners in Health Update
• Provider Bulletins
• Privacy Information (HIPAA)

For more information or assistance, please contact the EDI team or call the EDI Business Help Desk at 215-241-2305.

* Companion guides are under construction and subject to change post implementation.

Important information about links to other sites