WEDI Papers & Fact Sheets

The purpose of this white paper is to provide a baseline understanding of the models and definitions of health care encounters. Following an overview of encounters, it will explore various models and how data are exchanged between health care plans, payers, providers, and other entities, as well as define commonly used terms related to encounters. This paper will establish a foundation for future work on more detailed reviews of encounter models and identification of data needs.

Knowledge Center Episode 260- Beyond the Billing Code: Capturing the Clinical Picture July 22, 2019 Welcome to “Did You Know?”! In our recent acknowledgement survey, we identified a need to provide an issue brief providing education on some basic misunderstandings related to acknowledgements within HIPAA transaction exchange using the ASC X12 Version 005010 (5010). We…

Knowledge Center Episode 260- Beyond the Billing Code: Capturing the Clinical Picture May 20, 2019 The purpose of this paper is to provide guidance and information on the functionality and usage of the Provider Adjustment Segment (PLB) within the electronic remittance advice (ASC X12N 835 transaction) for specific business use cases, as described in the…

Knowledge Center Episode 260- Beyond the Billing Code: Capturing the Clinical Picture February 5, 2019 The observations, findings and recommendations that follow represent the output of the Council’s three phases of activity. The WEDI Prior Authorization Council Back to Knowledge Center Categories Comments & Letters Podcasts Press Releases Regulatory Updates SDOs & Operating Rules Updates…

Knowledge Center Episode 260- Beyond the Billing Code: Capturing the Clinical Picture October 5, 2018 The secure implementation of Electronic Funds Transfer (EFT) Enrollment for payment of health care claims has presented some challenges for health care entities. The purpose of this paper is to recommend best practices to protect the security of all entities…

Knowledge Center Episode 260- Beyond the Billing Code: Capturing the Clinical Picture October 4, 2018 Leading health care systems, clinical laboratories, vendors and health plans are all increasing their focus on providing precision medicine (PM) through the use of genetic and genomic information. Venture capital funding has increased exponentially in this space, with new technologies…

Knowledge Center Episode 260- Beyond the Billing Code: Capturing the Clinical Picture June 13, 2018 The purpose of this white paper is to provide guidance on how to populate the ASC X12N 005010X224A2 Health Care Claim: Dental (837D) electronic transaction from the data reported on the ADA Dental Claim Form (© 2012 American Dental Association).…

Knowledge Center Episode 260- Beyond the Billing Code: Capturing the Clinical Picture March 13, 2018 The purpose of this white paper is to provide information on the various modes of delivering patient care using telehealth services and technology, including virtual encounters, remote patient monitoring, wearable devices, and integrated care management. Telehealth Modalities Back to Knowledge…

Knowledge Center Episode 260- Beyond the Billing Code: Capturing the Clinical Picture November 17, 2017 This whitepaper is intended as a resource to aid the transition from the current, largely manual exchange of health care attachments to a more efficient, electronic process. This white paper is a resource document for implementers to use to help…