Yes, we can certify any HIPAA EDI Transaction. We do have apps to convert from 837IPD to XML; however, we don't use them much. If you need data - please ask for a quote, from EDI.Dallas@zoho.com. Mention that you need data for 834 enrollment; how many examples you need and what kind. Also mention if you want them all in one file or in separate 834 files.
In 834 we are enrolling member to a healthcare plan. Why do we need to specify a provider information in this file? we will need it if only a claim or payment is made right? Kindly clarify if my understanding is wrong.
For the 834 Enrollment Transaction, You DO NOT HAVE TO include the PCP (Primary Care Physician). This segment is in the 834, 2310 Loop, which is SITUATIONAL. The first segment is LX and it's value is "Situational". The next segment is the NM1 segment that you are referring to and it is listed as "Required".....but this is how it works: IF (IF) you use the LX Loop, THEN NM1, inside that loop, is Required. However, you do NOT HAVE TO use the LX loop in the 834 Enrollment Transaction. Hope this helps. :)
Monis, know that EACH Payer may handle Dependents differently; however, I would look for the 820 to reflect the 834's subscriber in the 2000B ENT segment and any Dependent details in the 2300B RMR and REF segments (See RMR-01 = "11" for Account Number or "IG" for Policy Number [of a Dependent]. This 2300B loop can repeat several times. Let me know if you need more :)
The 835 is payment for a doctor bill (837). The 820 is a Premium Payment for when someone buys health insurance - basically to pay the premium (820) for their enrollment (834)
What Business Analyst responsibilities in Health insurance company with the EDI 837 / 835 claim adjudications. What they do as a Business Analyst in EDI Transactions. Can you kindly share your email id I can send questions, and need more details if you can provide training on the same.
Can you help me in creating EDI or XML for different scenarios like create , terminate , reinstate , reenrol , retro add , retro term pls
Thank you sir
Do you provide any certifications on Edi transactions ?
Yes, we can certify any HIPAA EDI Transaction. We do have apps to convert from 837IPD to XML; however, we don't use them much. If you need data - please ask for a quote, from EDI.Dallas@zoho.com. Mention that you need data for 834 enrollment; how many examples you need and what kind. Also mention if you want them all in one file or in separate 834 files.
What does LX~ segment is called and used for
LX is used in the 837. It's a Service Line Number. It always starts with "1" and increments. Like this: LX*1~ .....SV1*...~ DTP*472*... LX1*2~....
In 834 we are enrolling member to a healthcare plan.
Why do we need to specify a provider information in this file? we will need it if only a claim or payment is made right?
Kindly clarify if my understanding is wrong.
For the 834 Enrollment Transaction, You DO NOT HAVE TO include the PCP (Primary Care Physician). This segment is in the 834, 2310 Loop, which is SITUATIONAL. The first segment is LX and it's value is "Situational". The next segment is the NM1 segment that you are referring to and it is listed as "Required".....but this is how it works: IF (IF) you use the LX Loop, THEN NM1, inside that loop, is Required. However, you do NOT HAVE TO use the LX loop in the 834 Enrollment Transaction. Hope this helps. :)
@@remorabay Thank you for the clarification sir. Your videos are examplary
How to include dependents information of the employee in EDI 834?
Monis, know that EACH Payer may handle Dependents differently; however, I would look for the 820 to reflect the 834's subscriber in the 2000B ENT segment and any Dependent details in the 2300B RMR and REF segments (See RMR-01 = "11" for Account Number or "IG" for Policy Number [of a Dependent]. This 2300B loop can repeat several times. Let me know if you need more :)
Seems like there are a lot of redundant information in the 834 file.
What is the difference between 835 and 820
The 835 is payment for a doctor bill (837). The 820 is a Premium Payment for when someone buys health insurance - basically to pay the premium (820) for their enrollment (834)
@@remorabay got it
What Business Analyst responsibilities in Health insurance company with the EDI 837 / 835 claim adjudications. What they do as a Business Analyst in EDI Transactions. Can you kindly share your email id I can send questions, and need more details if you can provide training on the same.
Alice, you can send me an email at EDI_Trainer@yahoo.com
@@remorabay I do have the same question as Alice. Can you please make a short video on the same if possible.