PracticeSuite EDI Enrollment FAQ

1. What is EDI? EDI stands for Electronic Data Interchange. It is the electronic exchange of data such as Claims, Electronic Remittance Advices and subscriber Eligibility transactions. In healthcare billing, Electronic Data Interchange (EDI) simplifies the process of sending information between the provider and insurance payer. 2. Why is EDI enrollment required? This is the […]

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How To Send Hospice Employee Indicator on EDI Claims?

Hospice Employee Indicator is required on Medicare Hospice claims. Segment CRC (Hospice Employee Indicator) is required on all Medicare claims involving physician services to Hospice patients. Hospice Employee Indicator is expected in Loop 2400>CRC with indicator 70. Missing indicator may result in claim rejection. How To Add  Hospice Employee Indicator Putting ‘CRC:70’ at line note […]

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How to set POA indicator in Institutional Claims?

Method 1: This sets the POA field of a single claim. User can enter a text POA in the Remarks field of UB04 Charge Entry that will populate the POA. Method 2: This updates the POA field of all claim sent to a specific payer or for all payers. EDI has a rule that will […]

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How to Show Delay Reason in Institutional Claims?

Enter the Delay reason code in UB04 charge entry screen column 80 “Remarks” as follows and the system will map accordingly in the EDI. DELAYCODE-<code> Valid codes are 1, 2, 3, 4, 5, 6, 7,8, 9, 10, 11, 15 Description for each delay code is available in the URL “http://www.reliablehealth.com/P3162.htm”

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How to Send Patient SSN on EDI claim file?

To send Patient SSN in the Claim: 1)  Go to Charge Master (Edit Charges screen) and navigate to the Encounter section. 2)  Move to Details tab and then click on the Others tab inside it. 3)  In the Claim Note/Special Instruction field, enter the SSN in the below given format. “SSN-<<ssn number>>” eg:  SSN-123456789 4)  […]

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