How can I find out more about HIPAA Implementation Guide edits and BCBSNC business edits?
Implementation Guide edits address issues such as the presence of required fields or fields required under certain conditions, the validation of data structure (e.g. alpha-numeric requirements, field length), and the correct usage of medical and non-medical code sets. Implementation Guide edits are identified through the TA1 or 997 Acknowledgment transactions. BCBSNC business edits address only those data elements that are required for business processing. For health care claims, our business edits are defined in the context of the 837 transactions in both Chapters 1 and 2 of the BCBSNC Companion Guide to EDI Transactions. The BCBSNC business edits are also listed in Appendices B and C of the BCBSNC Companion Guide to EDI Transactions, available at www.bcbsnc.com/content/providers/edi/hipaainfo.htm. Business edits are identified by either the BCBSNC Claims Audit Report (for 837 Claims filings) or by the paired transaction to a 270, 276, or 278. Those transmitting 834 files are notified
Related Questions
- How can BCBSNC be compliant with HIPAA regulations if the Companion Guide requests only specific values for certain elements within a transaction?
- Does BCBSNC have a Companion Guide to assist trading partners in the transmission of HIPAA compliant EDI transactions with BCBSNC?
- How can I find out more about HIPAA Implementation Guide edits and BCBSNC business edits?
