834 Companion Guide - Wa
State of WashingtonCompanion GuideTo theAccredited Standards Committee (ASC)X12Technical Report Type 3 (TR3)834 Benefit Enrollment and MaintenanceBased On Version 005010X220A1Prepared by:CNSIJanuary 2020i
DisclaimerExpress permission to use ASC X12 copyrighted materials has been granted.This companion guide contains data clarifications derived from specific business rules that applyexclusively to Washington State Medicaid processing for Washington State HCA. The guidealso includes useful information about receiving data from the Washington State ProviderOnesystem.ii
State of Washington ProviderOne5010 834 Companion GuideRevision HistoryDocumented revisions are maintained in this document through the use of the RevisionHistory Table shown below. All revisions made to this companion guide after the creationdate are noted along with the date, page affected, and reason for the change.Revision LevelDatePageDescriptionChange SummaryWAMMIS-CG834-501001-0112/15/2010Initial DocumentWAMMIS-CG834-501001-0203/01/2012Version number updateddue to the inclusion of fullCompanion GuideBoilerplate informationWAMMIS-CG834-501001-0304/2014Updated per ASC dated to includecomprehensive reasoncode listMCO and RSN deliveryschedule changed to reflect2016HD and DTP segmentupdate in regards to LivingArrangement andInstitutional ed to reflect newTransaction Reason,Maintenance Type &Maintenance ReasonCodesEnrollment Transaction ReasonSO –Incarceration/Suspension Override Maintenance Type 21 Maintenance Reason28Disenrollment IS –Incarceration/Suspension Maintenance Type 24 Maintenance Reason18iiiWAMMIS-CG834-5010-01-11
State of Washington ProviderOne5010 834 Companion GuideWAMMIS-CG834-501001-0610/20/2017Updated to reflect newTransaction Reason,Maintenance Type &Maintenance Reason CodeChange Transaction IM – Institution forMentally Diseased Maintenance Type001 Maintenance ReasonAIWAMMIS-CG834-501001-0712/15/2017Update to reflect newadditional usage of therepeated HD Segment toprovide FoundationalCommunity Supportelements whenappropriate.MCO and BHO reportschedule updated to reflect2018WAMMIS-CG834-501001-0806/01/2018Updated to reflect newTransaction Type,Transaction Reason,Maintenance Type &Maintenance Reason CodeDisenrollment RM – MedicarePart A/B/C Maintenance Type024 Maintenance Reason14WAMMIS-CG834-501001-0911/19/2018Updated to reflect newDDE IndicatorY YesN NoE Develop DisabledSpecial ServicesWAMMIS-CG834-501001-1012/26/2018MCO and BHO reportschedule updated to reflect2019WAMMIS-CG834-501001-1101/22/2020MCO and BHO reportschedule updated for 2020and PONE Screen printsivWAMMIS-CG834-5010-01-11
State of Washington ProviderOne5010 834 Companion GuideContentsDisclaimer . iiRevision History.iii1Introduction .61.1Document Purpose .61.1.1Intended Users .61.1.2Relationship to HIPAA Implementation Guides .61.2Transmission Schedule .72Technical Infrastructure and Procedures.82.1Technical Environment .82.1.1Communication Requirements .82.1.2Testing Process .82.1.3Who to contact for assistance .92.2Retrieve batches via Web Interface .102.3Set-up, Directory, and File Naming Convention.122.3.1SFTP Set-up .122.3.2SFTP Directory Naming Convention .122.3.3File Naming Convention .132.4Transaction Standards .132.4.1General Information .132.4.2Data Format .142.4.3Data Interchange Conventions .142.4.4Acknowledgement Procedures.152.4.5Rejected Transmissions and Transactions .153Transaction Specifications .164Reporting of Dates in the 834.2345MCO reporting schedule .286RSN reporting schedule .297Appendix A – Maintenance Reason Code . 33vWAMMIS-CG834-5010-01-11
State of Washington ProviderOne5010 834 Companion Guide1 IntroductionThe Administrative Simplification provisions of the Health Insurance Portability andAccountability Act of 1996 (HIPAA, Title II) includes requirements that nationalstandards be established for electronic health care transactions, and nationalidentifiers for providers, health plans, and employers. This requires WashingtonState Health Care Authority (HCA) to adopt standards to support the electronicexchange of administrative and financial health care transactions between coveredentities (health care providers, health plans, and healthcare clearinghouses).The intent of these standards is to improve the efficiency and effectiveness of thenation's health care system by encouraging widespread use of electronic datainterchange standards in health care. The intent of the law is that all electronictransactions for which standards are specified must be conducted according to thestandards. These standards were developed by processes that included significantpublic and private sector input.1.1 Document PurposeCompanion Guides are used to clarify the exchange of information on HIPAAtransactions between the HCA ProviderOne system and its trading partners. HCAdefines trading partners as covered entities that either submit or retrieve HIPAAbatch transactions to and from ProviderOne.This Companion Guide provides information about the 834 Enrollment file that isspecific to HCA and HCA trading partners. It will include both the 834 Audit and 834Update. This Companion Guide is intended for trading partner use in conjunctionwith the ASC X12 TR3 834 Benefit Enrollment and Maintenance version005010X220A1. The ASC X12 TR3s that detail the full requirements for all HIPAAmandated transactions are available at http://store.x12.org/store/.1.1.1 Intended UsersCompanion Guides are intended for members of the technical staffs oftrading partners who are responsible for electronic transaction/file exchanges.1.1.2 Relationship to HIPAA Implementation GuidesCompanion Guides are intended to supplement the ASC X12 TR3 HIPAAtransactions. Rules for format, content, and field values can be found in theImplementation Guides. This Companion Guide describes the technicalinterface environment with HCA, including connectivity requirements andprotocols, and electronic interchange procedures. This guide also providesspecific information on data elements and the values required for transactionssent to or received from HCA.6WAMMIS-CG834-5010-01-11
State of Washington ProviderOne5010 834 Companion GuideCompanion Guides are intended to supplement rather than replace the ASCX12 TR3 for each transaction set. The information in these documents is notintended to: Modify the definition, data condition, or use of any data element orsegment in the standard Implementation Guides. Add any additional data elements or segments to the defined data set. Utilize any code or data values that are not valid in the standardImplementation Guides. Change the meaning or intent of any implementation specifications inthe standard Implementation Guides.1.2 Transmission ScheduleThe 834 audit files will be posted a day after the Medicaid Enrollment Cut-Off Date. The834 daily update files will be posted after 12 AM PST.7WAMMIS-CG834-5010-01-11
State of Washington ProviderOne5010 834 Companion Guide2 Technical Infrastructure and Procedures2.1 Technical Environment2.1.1 Communication RequirementsThis section will describe how trading partners will receive 834 Transactionsfrom HCA using two methods: Secure File Transfer Protocol (SFTP) ProviderOne Web Portal2.1.2 Testing ProcessCompletion of the testing process must occur prior to production electronicretrieval from ProviderOne. Testing is conducted to ensure the following formaintaining HIPAA guidelines:1. Syntactical integrity: Testing of the EDI file for valid segments,segment order, element attributes, testing for numeric values innumeric data elements, validation of X12 or NCPDP syntax, andcompliance with X12 and NCPDP rules.2. Syntactical requirements: Testing for HIPAA Implementation Guidespecific syntax requirements (such as limits on repeat counts),qualifiers, codes, elements and segments. This process should alsoinclude testing for HIPAA required or situational data elements,medical code sets, and values and codes noted in the ImplementationGuide via an X12 code list or table.Additional testing may be required in the future to verify any changes made tothe ProviderOne system. Changes to the formats may also require additionaltesting. Assistance is available throughout the testing process.Trading Partner Testing Procedures1. ProviderOne companion guides and trading partner enrollmentpackage are available for download via the web .aspx2. The Trading Partner completes the Trading Partner Agreement andsubmits the signed agreement to HCA.Submit to:HCA HIPAA EDI Department626 8th Avenue SEPO Box 45564Olympia, WA 98504-55648WAMMIS-CG834-5010-01-11
State of Washington ProviderOne5010 834 Companion Guide**For Questions call 1-800-562-30223. The trading partner is assigned a Submitter ID, Domain, Logon UserID and password.4. ProviderOne system processes and validates all outbound HIPAA testfiles. It will be available for download via the ProviderOne web portalor Secure File Transfer Protocol (SFTP). Web Portal URL: https://www.waproviderone.org/ediSFTP URL: sftp://ftp.waproviderone.org/5. The trading partner downloads the file from the ProviderOne webportal or Secure File Transfer Protocol (SFTP).6. If the test file download is successful and the trading partner’s systemaccepts the file for processing, the trading partner is approved fortransaction download in the ProviderOne production environment.7. If the test file download is unsuccessful, the trading partner shouldimmediately email HIPAA-help@HCA.wa.gov to report the failure.Testing will continue in the test environment until a successfuldownload is completed.2.1.3 Who to contact for assistanceEmail: hipaa-help@hca.wa.govo All emails result in the assignment of a Ticket Number forproblem trackingInformation required for initial email:oNameoPhone NumberoEmail Addresso7-digit domain/ProviderOne IDoTransaction you are inquiring aboutoFile NameoDetailed description of the concernInformation required for follow up:oAssigned Ticket Number9WAMMIS-CG834-5010-01-11
State of Washington ProviderOne5010 834 Companion Guide2.2 Retrieve batches via Web InterfaceLog into the ProviderOne Portal, select the appropriate security profile and thefollowing options will be presented to the user:Scroll down to the HIPAA heading to manage the submission and retrieval ofHIPAA transactions.10WAMMIS-CG834-5010-01-11
State of Washington ProviderOne5010 834 Companion GuideSelect Retrieve HIPAA Batch Responses option from the main screen to retrieve HIPAAOutbound files (TA1, 999, 271, 277, 820, 834, 835, 277U) as shown below:11WAMMIS-CG834-5010-01-11
State of Washington ProviderOne5010 834 Companion Guide2.3 Set-up, Directory, and File Naming Convention2.3.1 SFTP Set-upTrading partners can contact hipaa-help@hca.wa.gov for information onestablishing connections through the SFTP server. Upon completion of set-up,they will receive additional instructions on SFTP usage.2.3.2 SFTP Directory Naming ConventionThere would be two categories of folders under Trading Partner’s SFTPfolders:1. TEST – Trading Partners should submit and receive their testfiles under this root folder2. PROD – Trading Partners should submit and receive theirproduction files under this root folder3. README – This folder will include messages regardingpassword update requirements, outage information and generalSFTP messages.Following folder will be available under TEST/PROD folder within SFTProot of the Trading Partner:‘HIPAA Inbound’ - This folder should be used to drop the Inbound filesthat needs to be submitted to HCA‘HIPAA Ack’ - Trading partner should look for acknowledgements to thefiles submitted in this folder. TA1, 999 and custom error report will beavailable for all the files submitted by the Trading Partner‘HIPAA Outbound’ – X12 outbound transactions generated by HCA willbe available in this folder‘HIPAA Error’ – Any inbound file that is not HIPAA compliant or is notrecognized by ProviderOne will be moved to this folder‘HIPAA Working’ – There is no functional use for this folder at this time12WAMMIS-CG834-5010-01-11
State of Washington ProviderOne5010 834 Companion GuideFolder structure will appear as:2.3.3 File Naming ConventionHIPAA files are named in the following format.For Outbound transactions:HIPAA. TPId . datetimestamp . TxID .O. out Example of file name: HIPAA.123456700.12262007211315.834.O.out TPId is the Trading Partner Id datetimestamp is the Date timestamp TxID is the Transaction Id.2.4 Transaction Standards2.4.1 General InformationHIPAA standards are specified in the Implementation Guide for eachmandated transaction and modified by authorized Addenda. Currently, the834 Enrollment and Maintenance has one Addendum. This Addendum hasbeen adopted as final and is incorporated into HCA requirements.The ASC X12 TR3 834 Benefit and Enrollment Maintenance containsinformation related to: Format and content of interchanges and functional groups13WAMMIS-CG834-5010-01-11
State of Washington ProviderOne5010 834 Companion Guide Format and content of the header, detail and trailer segments specificto the transaction Code sets and values authorized for use in the transaction Allowed exceptions to specific transaction requirementsTransmission sizes are limited based on two factors: Number of Segments/Records allowed by HIPAA standards HCA file transfer limitationsHCA has no size limitations for postings to its SFTP Server.2.4.2 Data FormatDelimitersThe ProviderOne will use the following delimiters on outbound transactions: Data element separator, Asterisk, ( * ) Sub-element Separator, Vertical Bar, ( : ) Segment Terminator, Tilde, ( ) Repetition Separator, Caret, ( )2.4.3 Data Interchange ConventionsWhen transmitting 834 transactions, HCA follows standards developed byASC X12. These standards involve Interchange (ISA/IEA) and FunctionalGroup (GS/GE) Segments or “outer envelopes”. All 834 transactions areenclosed in transmission level ISA/IEA envelopes and, within transmissions,functional group level GS/GE envelopes. The segments and data elementsused in outer envelopes are documented in Appendix B1 of the ASC X12TR3 834 Implementation Guide. Specific information on how individual dataelements are populated by HCA on ISA/IEA and GS/GE envelopes areshown in the table beginning later in this section.HCA transmits 834 Transaction files with single ISA/IEA and GS/GEenvelope. 834 Transactions will have 10,000 members per ST-SE segmentand may have multiple transaction sets within the same GS/GE envelope.14WAMMIS-CG834-5010-01-11
State of Washington ProviderOne5010 834 Companion Guide2.4.4 Acknowledgement ProceduresN/A2.4.5 Rejected Transmissions and TransactionsHCA will validate all 834 transactions up to HIPAA validation levels 1 and 2. If areceiver rejects any part of a transmission, they must reject the entiretransmission. Data on rejected 834 transmissions should not be used to updatereceiver’s databases as HCA will resend a corrected full-file replacement. HCAtransmits 834 Transactions within a single functional group, even when multipletransactions (ST through SE Segments) are required.15WAMMIS-CG834-5010-01-11
State of Washington ProviderOne5010 834 Companion Guide3 Transaction SpecificationsPageLoopSegmentDataElementElement NameCommentsInterchange Control HeaderApp. CHeaderISA01AuthorizationInformationQualifierApp. CHeaderISA03SecurityInformationQualifierApp. CHeaderISA05App. CHeaderISA06Interchange IDQualifierInterchangeSender IDApp. CHeaderISA07App. CHeaderISA08App. CHeaderISA11App. paratorFunctional Group HeaderApp. CHeaderGS02ApplicationSender’s CodeApp. CHeaderGS03ApplicationReceiver’s CodeInterchange IDQualifierInterchangeReceiver IDThis field will bepopulated with ‘00’ –No Authorizationinformation.This field will bepopulated with ‘00’ –No Securityinformation.This field will bepopulated with ‘ZZ’.This field will bepopulated with‘77045’- WA StateDSHS Sender IDThis field will bepopulated with ‘ZZ’This field will bepopulated with the 9Digit ProviderOne IDof the receiver.Use for repetitionseparator.This field will bepopulated with Value ":"This field will bepopulated with ‘77045’- WA State DSHSSender IDThis field will bepopulated with the 9Digit ProviderOne IDof the receiver.16WAMMIS-CG834-5010-01-11
State of Washington ProviderOne5010 834 Companion GuideBeginning Segment01Transaction SetPurpose n35HeaderBGN08Action Code‘00’ – Original. Copy ofthe original will beavailable from archive.This field will bepopulated with theSender’s ReferenceNumberValues to be received:‘2’ Change (Update)‘4’ Verify (Audit)Transaction Set Policy Number Segment36HeaderREF02ReferenceIdentificationThis filed will bepopulated with the 9digit ProviderOneHealth Plan ProviderID Number(1st 7 digits – numeric,last 2 digits – alphanumeric) e.g.1234567AA,567895401Sponsor is field will bepopulated with ‘WAState DSHS’This field will bepopulated with ‘916001088’.Payer is field will bepopulated with thePayer Name (i.e.Columbia UnitedProviders; Molina,Regence etc.)This field will bepopulated with thePayer TaxID/EmployerIdentification Number17WAMMIS-CG834-5010-01-11
State of Washington ProviderOne5010 834 Companion GuideSubscriber Identifier552000REF02ReferenceIdentificationThis field is populatedwith MedicaidProviderOne ClientIdentification Numberin the following format.9-digit numeric and 2digit alpha.e.g. 123456789WAMember Policy Number562000REF02ReferenceIdentificationNumberThis field will bepopulated with the 9digit ProviderOneHealth Plan ProviderID Number(1st 7 digits – numeric,last 2 digits – alphanumeric) e.g.1234567AA ,567895401Member Supplemental lifierRecipient �'17' (when available)‘DX’ (when applicable)Note: WA StateMedicaid will onlyreport the fivequalifiers above.The qualifiers will alsobe reported in theorder as referencedabove.18WAMMIS-CG834-5010-01-11
State of Washington ProviderOne5010 834 Companion GuideMember Level Dates592000DTPRefer to section 4“Reporting of Dates inthe 834” for the datesreported for eachmaintenance typecode.Member nCodeThis field is populatedwith the MedicaidClient’s SocialSecurity Number(when available).Member Residence City, State, Zip CodeLocationIdentifierIncorrect Member Name09IdentificationCodePopulated with theRate Region CodePrior incorrect insuredSocial SecurityNumber (whenavailable).19WAMMIS-CG834-5010-01-11
State of Washington ProviderOne5010 834 Companion GuideCustodial TE: Will be used toretain the name of anewborn’s mother.Mother’s SocialSecurity Number(when available).Responsible Person1232100GNM1Note:Will be used to reportthe head of cationCodeHealth Coverage04Plan CoverageDescriptionHead of householdSocial SecurityNumber (Whenavailable).This data element has50 characters and iscoded as follows:Rate CohortCombination (5 N)Premium DeterminantRAC (4 AN)Medicare Status(2 AN)*Pregnancy Due Date(8 N (MMDDYYYY))*Self-Assessment(1 AN)*Special NeedsIndicator (1 AN)Surgery Date(8 N (MMDDYYYY))20WAMMIS-CG834-5010-01-11
State of Washington ProviderOne5010 834 Companion GuideRecertification Date(8 N (MMDDYYYY))PRR Indicator (1 AN)Client ExceptionIndicator (1 AN)Expected DeliveryDate(8 N (MMDDYYYY))Transaction Reason(2 AN)Health Home ClinicalIndicator (1 AN)‘*’ Identifies Datacollected from ClientEnrollment Form1412300HD04Plan CoverageDescriptionThe HD segment willrepeat to provideLiving Arrangement,Institutional Status,FoundationalCommunity Support,and DevelopmentalDisability Enrolledinformation asavailable. This dataelement has 50characters and will becoded as follows:Living Arrangement(2 AN)Institutional Status(2 AN)FoundationalCommunity Supports(1 A)21WAMMIS-CG834-5010-01-11
State of Washington ProviderOne5010 834 Companion GuideDevelopmentalDisability Enrolled(1A)Health Coverage Dates14314423002300DTPDTPPlease refer section 4“Reporting of Dates inthe 834” for the datesreported for eachmaintenance typecode.03Date TimePeriodThis DTP segment willrepeat if LivingArrangement orInstitutional Statusinformation isavailable.CCYYMMDDDate Plan CoverageBegins/Ends inUpdate file or first dayof the Month (forwhich premium info isbeing sent) in theAudit file.Provider Name1552310NM109IdentificationCodeThis field will bepopulated with theProvider NPI. If theNPI is not available,the Providerinformation will bepopulated in NM103,NM104, NM105.Coordination of Benefits Related Entity1702330NM1NM109IdentificationCodeThis field will bepopulated with theFederal Taxpayer’sIdentification Numberof the COB Payer (ifavailable).22WAMMIS-CG834-5010-01-11
State of Washington ProviderOne5010 834 Companion Guide4Reporting of Dates in the 834Dates reported on the 834 will vary based on the type of file being sent, i.e. Audit or Update.Within the Update file the dates reported will vary dependent upon the nature of the transaction,i.e. enrollment, disenrollment, change to coverage, or a demographic change that does notimpact coverage. Please see the table below for a detailed definition of usage.AuditAuditAuditAuditTransactionTypeMonthly 834 Audit FileMaintenance TypeLoop,CodeSegment,DateQualifierLoop 2000,DTP01NotReportedLoop 2300,DTP01‘303’ –TransactionEffectiveDate‘030’ AuditLoop 2300,DTP01‘348’ –Health PlanCoverageBegin Date‘030’ AuditLoop 2300,DTP01‘349’ –Health PlanCoverageEnd Date‘030’ Audit‘030’ AuditNotesLoop 2000Member leveldates are notreturned on anAudit File‘303’ is first dayof reportingperiod, and isreportedonly when themember isreported on theprevious monthsAudit File‘348’ is used onan Audit File toreport HealthPlan CoverageBegin date‘349’ is used onan Audit Filewhen membercoverage endsin Audit reportingmonth.23WAMMIS-CG834-5010-01-11
State of Washington ProviderOne5010 834 Companion GuideMonthly 834 Update FileChange impactingcoverageChange impacting coverageChange impactingcoverageTransaction Maintenance TypeTypeCode‘001’ Change(Change that impactsCoverage)‘001’ Change(Change that impactsCoverage)‘001’ Change(Change that impactsCoverage)Loop,Segment,Loop 2000,DTP01Loop 2000,DTP01Loop 2300,DTP01DateQualifierNotes‘473’ –MedicaidEligibilityBegin Date‘473’ will beused at Loop2000 MemberLevel Date topass themember’sMedicaideligibility begindate.‘474’ –MedicaidEligibilityEnd DateFor changeeffectingcoverage ‘474’will be used atLoop 2000Member leveldate to passMemberMedicaidEligibility Enddate.‘303’ TransactionEffectiveDate‘303’ is used onan Update Fileat Loop 2300HealthCoverage LevelDates to identifythe actual dateof change incoverage.24WAMMIS-CG834-5010-01-11
Change thatdoes not impactcoverageChange that doesnot impact coverageChange impacting coverageChange impacting coverageState of Washington ProviderOne5010 834 Companion Guide‘001’ Change(Change that impactsCoverage)‘001’ Change(Change that impactsCoverage)‘001’ Change(Change that does notimpact Coverage)‘001’ Change(Change that does notimpact Coverage)Loop 2300,DTP01Loop 2300,DTP01Loop 2000,DTP01Loop 2300,DTP01‘348’ –Health PlanCoverageBegin Date‘348’ is used onan Update Fileat Loop 2300HealthCoverage LevelDates to providebegin date ofnew coverageor the updatedHealth plancoverage begindate.‘349’ –Health PlanCoverageEnd DateFor changeeffectingcoverage ‘349’will be used atLoop 2300HealthCoverage LevelDate to pass themember’sHealth Plancoverage enddate.‘303’ –TransactionEffectiveDateNotReported‘303’ is used onan Update Fileat Loop 2000Member leveldates to identifythe actual dateof change thatdoes not impactcoverageWhen reportinga change thatdoes not impactcoverage, Loop2300 is notreturned per theIG.25WAMMIS-CG834-5010-01-11
State of Washington ProviderOne5010 834 Companion GuideEnrollment‘021’ AdditionEnrollment‘021’ AdditionLoop 2000,DTP01Loop 2300,DTP01Enrollment‘021’ AdditionLoop 2000,DTP01Loop 2300,DTP01Enrollment‘021’ Addition‘473’ –MedicaidEligibilityBegin DateFor newenrollees ‘473’will be used atLoop 2000Member LevelDate to pass themember’sMedicaideligibility begindate‘474’ –MedicaidEligibilityEnd DateFor newenrollees ‘474’will be used atLoop 2000Member leveldate to passMemberMedicaidEligibility Enddate.‘348’ –Health PlanCoverageBegin DateFor newenrollees ‘348’will be used atLoop 2300HealthCoverage LevelDate to pass themember’sHealth PlanCoverageeligibility begindate‘349’ –Health PlanCoverageEnd DateFor newenrollees ‘349’will be used atLoop 2300HealthCoverage LevelDate to pass themember’sHealth PlanCoverageeligibility enddate26WAMMIS-CG834-5010-01-11
‘474’ –MedicaidEligibilityEnd DateDisenrollmentLoop 2000Member leveldate will only beused when thetermination ofeligibility withthe plan is dueto loss ofMedicaideligibility –otherwise Loop2000 Memberlevel dates willnot bepopulated ondisenrollments.DisenrollmentState of Washington ProviderOne5010 834 Companion Guide‘349’ –Health PlanCoverageEnd DateFordisenrollments‘349’ will beused at Loop2300 HealthCoverage LevelDate to pass themember’sHealth Plancoverage enddate.‘024’ Termination‘024’ TerminationLoop 2000,DTP01Loop 2300,DTP0127WAMMIS-CG834-5010-01-11
State of Washington ProviderOne5010 834 Companion Guide5 MCO reporting schedule2020 Reporting Schedule for all Medical ProgramsCoverage PeriodReportingTransactionEnrollmentCut-off834 Audit/820Full PaymentGenerationDaily 834Update 820 InterimPaymentGenerationDaily 834Update –820 InterimPaymentGenerationDaily 834Update –820 InterimPaymentGenerationDaily 834Update –820 34-5010-01-11N/A12/31
State of Washington ProviderOne5010 834 Companion Guide6 BHO reporting schedule2020 Reporting Schedule for all BHO ProgramsCoverage PeriodReportingTransactionEnrollmentCut-off834 Audit/820Full PaymentGenerationWeekly 834Update/820InterimPaymentGenerationWeekly 834Update/820InterimPaymentGenerationWeekly 834Update/820InterimPaymentGenerationWeekly 834Update/820InterimPaymentGenerationWeekly 5010-01-11N/AN/A
State of Washington ProviderOne5010 834 Companion GuideAppendix A - Maintenance Reason odeAABHTransactionReason CodeDescriptionAutoAssignmentBHP EnrollmentClientMaintenanceReason 28InitialEnrollmen
This Companion Guide provides information about the 834 Enrollment file that is specific to HCA and HCA trading partners. It will include both the 834 Audit and 834 Update. This Companion Guide is intended for trading partner use in conjunction with the ASC X12 TR3 834
834 EDI Companion Guide Introduction ASC X12 005010 834 Enrollment Implementation Format is a standard format for electronically exchanging health plan enrollment data. An 834 file contains a string of data elements and each data element represents a fact, such as a subscriber’s name, hire
AULTCARE 834-5010 COMPANION GUIDE INTRODUCTION Why a companion guide? Doesn’t the HIPAA implementation guide tell me everything I need to know? he objective of the guide is not to report all of the required data in the implementation guide. The HIPAA implementation guide contains many optional data specifications. This companion
Updated 10/14/2012 Nevada MMIS 834 Transaction Companion Guide (PV 02/03/2012) 5. Control segments/envelopes NOTE: The page numbers listed below in each of the tables represent the corresponding page number in the X12N 834 HIPAA Implementation Guide. X12N EDI Control Segments ISA – Interchange Control Header Segment
This Companion Guide contains detailed information about how the Exchange will use the CMS Standard Companion Guide Transaction v1.7 and the ASC X12 Benefit Enrollment and Maintenance (834) transaction, based on the 005010X220 Implementation Guide and File Size: 642KB
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