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Electronic Data
Interchange (EDI) Documents
The Regence Group claims documents accompany the transactions
specified in the ANSI ASC X12N Implementation Guide
and Addenda available from the Washington Publishing
Company, Rockville, MD. These documents are intended
for use by insurance claim submitters, software systems
vendors, physicians, dentists, hospitals, other health-care
provider organizations and facilities, and others involved
in the Electronic Data Interchange (EDI) process.
They provide detailed information specifying how to:
- Implement The Regence Group unique Health Insurance
Portability and Accountability Act of 1996 (HIPAA)
transaction requirements
- Maintain consistency with our claims information
processing system assumptions, approaches, configurations,
and conventions
- Minimize implementation obstacles
- Reconcile data element errors
Below are Electronic Data Interchange (EDI) documents
for sending HIPAA content compliant transactions to
Regence Group Plans through our contracted clearinghouse,
Availity, LLC.
For questions, please contact the Availity, LLC EDI Helpline
at 1 (800) 713-1693.
| HIPAA
Content Compliant Formats
Electronic claims formats, developed in conjunction
with Availity, LLC, accepted by Regence Plans as Health
Information Portability and Accountability Act
of 1996 (HIPAA) content compliant. |
| NSF
T0301 Expanded |
National
Standard Format specifications, version 3.01 expanded,
for Professional and Dental electronic health
care claims. |
| UB92
T60 Expanded |
Uniform
Billing Format specifications, version 6.0 expanded,
for Institutional electronic health care claims. |
| Other
Regence Plan EDI Documents |
| EDI
Transaction Enrollment Form (PDF) |
Form enables enrollment
in the following electronic transactions:
- 835 Electronic Remittance Advice
- 270/271 Eligibility Request and Response
- 276/277 Claim Status Inquiry and Response
- 278 Referrals & Pre-Certifications Inquiry
and Response
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| EDI
User Manual |
User
Manual of requirements for HIPAA transaction EDI
with Regence Plans. |
For More Information:
Contact Regence EDI Support at 1 (800) 713-1693 or by
e-mail at EDIsupport@regence.com.
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