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This document provides detailed instructions for providers and their business associates on conducting electronic transactions with Highmark West Virginia and HHIC, including compliance with HIPAA
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How to fill out highmark west virginia provider
How to fill out Highmark West Virginia Provider EDI Companion Guide
01
Obtain the latest version of the Highmark West Virginia Provider EDI Companion Guide from the official website.
02
Review the introduction section to understand the purpose and scope of the guide.
03
Familiarize yourself with the required EDI transaction sets specific to your services.
04
Complete the provider information section with accurate details including NPI and Tax ID.
05
Follow the instructions for setting up software configurations for EDI submission.
06
Verify the necessary data elements for each transaction type according to the guide specifications.
07
Test your EDI submissions using the guidelines provided in the testing section.
08
Keep a copy of your completed documentation for future reference and compliance.
Who needs Highmark West Virginia Provider EDI Companion Guide?
01
Healthcare providers submitting claims to Highmark West Virginia.
02
Billing staff who manage electronic claims and remittance processes.
03
IT personnel responsible for EDI system integrations.
04
Administrative staff coordinating with insurers for payer-specific requirements.
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People Also Ask about
What is the phone number for Highmark BCBS West Virginia?
West Virginia Medical and Behavioral Health Services800-344-5245 Medicare Advantage Freedom Blue PPO 800-269-6389 Pharmacy (non-Medical Injectable) For Medical Injectable authorizations, use the Medical Clinical Services number. 800-600-2227 Hours of Availability: 8 a.m. to 5 p.m. EST, Monday through Friday
What is the phone number for BCBS Highmark, WV?
Contact Us For more information please contact a Health Promotion Consultant by phone at (304) 424-7767 or the Wellness Resource Center at (800) 625-8442.
How do I speak to someone at Highmark?
Contact Us. For questions related to conducting EDI business with Independence via the Highmark Gateway, please call Highmark EDI Operations at 1-800-992-0246. Highmark EDI Operations is available Monday through Friday, 8 a.m. to 4:30 p.m., ET.
Are Highmark and Highmark Blue Shield the same?
The Pennsylvania Medical Society backed the founding of Pennsylvania Blue Shield (now Highmark Blue Shield). In 1996, the two Blue plans were consolidated, forming Highmark Inc. Highmark is now one of the largest health insurers in the United States.
What is the local BCBS for WV?
BCBS Companies STATE/TERRITORYAVAILABLE COMPANIES Washington Premera Blue Cross Regence BlueShield West Virginia Highmark Blue Cross Blue Shield West Virginia Wisconsin Anthem Blue Cross and Blue Shield Wisconsin Wyoming Blue Cross Blue Shield of Wyoming48 more rows
What is an EDI companion guide?
Our Electronic Data Interchange (EDI) Companion Guides describe specific requirements for trading partners who exchange electronic transactions directly with Blue Shield of California Promise Health Plan (not through a vendor or clearinghouse).
What is timely filing for BCBS West Virginia?
Timely Filing Policy If timely filing is not established within your contract, claims must be received within 365 days of the last date of service in Pennsylvania and West Virginia, and within 180 days of the date of service in Delaware, unless the member's policy provides for a different period.
What is Highmark EDI?
Welcome to the EDI Trading Partner Business Center. EDI (Electronic Data Interchange) is the standard format for exchanging business data computer-to-computer.
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What is Highmark West Virginia Provider EDI Companion Guide?
The Highmark West Virginia Provider EDI Companion Guide is a document that provides specific information and instructions for healthcare providers on how to format and submit Electronic Data Interchange (EDI) transactions to Highmark West Virginia.
Who is required to file Highmark West Virginia Provider EDI Companion Guide?
Healthcare providers and organizations that wish to submit electronic claims and other transactions to Highmark West Virginia are required to follow the guidelines set forth in the Provider EDI Companion Guide.
How to fill out Highmark West Virginia Provider EDI Companion Guide?
To fill out the Highmark West Virginia Provider EDI Companion Guide, providers should carefully review each section of the guide, adhere to the formatting and data requirements specified, and ensure that all necessary information is included before submitting their electronic transactions.
What is the purpose of Highmark West Virginia Provider EDI Companion Guide?
The purpose of the Highmark West Virginia Provider EDI Companion Guide is to facilitate accurate and efficient electronic transactions between healthcare providers and the Highmark West Virginia insurance system, ensuring compliance with standards and improving the claims process.
What information must be reported on Highmark West Virginia Provider EDI Companion Guide?
The Highmark West Virginia Provider EDI Companion Guide must report information such as provider identifiers, claim details, patient demographics, service codes, and any necessary attachments or documentation relevant to the EDI transactions.
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