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HIPAA - EDI Services

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HIPAA Claims Processing Package - 4010A1 Information

Some of the following documents are provided using Adobe's® Portable Document Format (PDF). In order to view and print PDF documents, you must first download the current Adobe Reader®. Adobe Reader is free and available for all major computer platforms. Download Adobe Reader from Adobe's Web site.

The following information was sent to all EDI software vendors and was designed to introduce new HIPAA related processing requirements for claims and remittance.

HIPAA Testing Fact Sheet
HIPAA EDI Trading Partner Agreement/Companion Document (Updated January 2008)
CMS-1500 Requirements Crosswalk (165KB) (Updated June 2008)
UMD Edit and Reporting Process
Batch Detail Control Report - RAR04 - Example - (14KB) (Updated December 2006)
Pre-Pass Edits for Submitters (288KB) (Updated April 2008)

HIPAA and Medicare Edit Updates

Pre-Translation Edits
997 Default Values
X12N Professional IG Addenda Information
Medicare X12N 835 Version 4010/4010A1 HIPAA Companion Document (Updated January 2008)

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This page updated
June 20, 2008