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ICD‐10 Testing for Small Providers

Knowledge Center Episode 232- The Role of Intermediaries in CMS-0057F February 24, 2015 This white paper provides a starting point for small physician practices performing ICD- 10 testing. (CMS defines a small physician/provider practice as having one to five physicians providing single or multi-specialty services.) This paper categorizes testing tasks under who, what, where, when,…

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ICD-10 Terminology

Knowledge Center Episode 232- The Role of Intermediaries in CMS-0057F January 22, 2015 The purpose of this Issue Brief is to provide an overall definition and understanding of some key terms used in the discussion of ICD-10 testing, implementation and risk management. The intent is to eliminate confusion in the use of these terms in…

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Reassociating Healthcare Payments

Knowledge Center Episode 232- The Role of Intermediaries in CMS-0057F December 9, 2014 Payments and remittance information can be received in a variety of formats, but still need to go through the reassociation process. Payments can be received via paper check or EFT, remittance advices can be received as a paper EOB, or as an…

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NDC Reporting Requirements in Health Care Claims

Knowledge Center Episode 232- The Role of Intermediaries in CMS-0057F October 28, 2014 The purpose of this white paper is to provide additional information on how to report National Drug Codes (NDC) and its related information in health care claims when it is known to impact adjudication. NDC Reporting Requirements in Health Care Claims Back…

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What is the Difference Between a Health Plan and a Payer?

Knowledge Center Episode 232- The Role of Intermediaries in CMS-0057F July 24, 2014 The Workgroup for Electronic Data Interchange (WEDI) has conducted ongoing conversations with the Centers for Medicare & Medicaid (CMS) and through those discussions, identified that there are differences in verbiage usage between the terms “health plan” and “payer”. By and large, the…

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The 2013 WEDI Report

Knowledge Center Episode 232- The Role of Intermediaries in CMS-0057F The WEDI Report was published in 1993 and provided a vision for the industry to successfully transition to electronic data interchange standards as a way to bring cost-efficiencies to burdensome administrative processes.  The report led directly to the administrative simplification provisions in the Health Insurance…

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Health Identification Card Implementation Guide

Knowledge Center Episode 232- The Role of Intermediaries in CMS-0057F April 28, 2011 This implementation guide specifies WEDI Health Identification Card Implementation of the American National Standard, Identification Cards—Health Care Identification Cards, INCITS 284 as revised. INCITS is accredited by ANSI. This Guide specifies uniform information, appearance, and technology. Health Identification Card Implementation Guide Back…

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Transaction Compliance and Certification

Knowledge Center Episode 232- The Role of Intermediaries in CMS-0057F March 10, 2010 A White Paper describing the recommended solutions for compliance testing and certification of the HIPAA transactions. Transaction Compliance and Certification Back to Knowledge Center Categories Comments & Letters Podcasts Press Releases Regulatory Updates SDOs & Operating Rules Updates Videos WEDI Blog WEDI…

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