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An 834 file contains a string of data elements, with each representing a fact, such as a subscriber’s name, hire date, etc. The entire string is called a transaction set. The 834 is used to transfer enrollment information from the sponsor of the insurance coverage, benefits, or policy to a payer. The format attempts to meet the health care ...
An explanation of benefits (commonly referred to as an EOB form) is a statement sent by a health insurance company to covered individuals explaining what medical treatments and/or services were paid for on their behalf. [1] The EOB is commonly attached to a check or statement of electronic payment. An EOB typically describes: the payee, the ...
Electronic data interchange. Electronic data interchange (EDI) is the concept of businesses electronically communicating information that was traditionally communicated on paper, such as purchase orders, advance ship notices, and invoices. Technical standards for EDI exist to facilitate parties transacting such instruments without having to ...
Electronic remittance advice. An electronic remittance advice (ERA) is an electronic data interchange (EDI) version of a medical insurance payment explanation. It provides details about providers' claims payment, and if the claims are denied, it would then contain the required explanations. The explanations include the denial codes and the ...
An electronic data interchange personal identifier, or EDIPI, is a number assigned to a record in the United States Department of Defense's Defense Enrollment and Eligibility Reporting System (DEERS) database. A record in the DEERS database is a person plus personnel category (e.g. contractor, reservist, civilian, active duty, etc.).
The Health Insurance Portability and Accountability Act of 1996 (HIPAA or the Kennedy – Kassebaum Act[1][2]) is a United States Act of Congress enacted by the 104th United States Congress and signed into law by President Bill Clinton on August 21, 1996. [3] It aimed to alter the transfer of healthcare information, stipulated the guidelines by ...
WEDI, pronounced "wee dee", is a not-for-profit user group in the United States for users of Electronic Data Interchange (EDI) in public and private healthcare. It is sometimes referred to by other names including some or all of the words Workgroup for Electronic Data Interchange . [1] By: Hipaasuite It was established to provide leadership and ...
Medi-Cal. The California Medical Assistance Program (Medi-Cal or MediCal) is the California implementation of the federal Medicaid program serving low-income individuals, including families, seniors, persons with disabilities, children in foster care, pregnant women, and childless adults with incomes below 138% of federal poverty level.
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