For Trading Partners
Health Insurance Portability and Accountability Act of 1996
Before conducting electronic data interchange (EDI) for HIPAA electronic transactions with us, trading partners must complete an authorization process. This process includes completing an "EDI Transaction Application form" and executing an "EDI Trading Partner Agreement" with us based upon the type of arrangement desired. The agreement is available from the EDI Trading Partner Business Center website.
National Implementation Guides
The ASC X12 005010 implementation guides and addenda documents are downloadable for a fee from the Washington Publishing Company's website.
In addition, we have published a set of companion documents to the national implementation guides that specify business requirements and clarifications for submitting transactions to us. For the Provider, the v5010 Provider Companion Guide is our companion document for the Claim, Claim Acknowledgment, Claim Payment Advice, Claim Status, Eligibility and Services Review HIPAA transactions. For the Employer/Sponsor, the v5010 Employer/Sponsor Companion Guide is our companion document for the Enrollment and Premium Payment HIPAA transactions. View our trading partner EDI Companion Guides on the EDI Trading Partner Business Center website.