HIPAA Transactions

We support all HIPAA compliant electronic transactions.

Transaction Transaction Number Companion Guide/ Help Materials EDI Setup Form
Health Care Eligibility Benefit Inquiry and Response
270/271
Companion Guide  270 EDI Setup Form 
Provider Portal Benefits Eligibility can be confirmed real-time through our Provider Portal. Please visit Tools & Resources for additional information on the Provider Portal. To enroll please contact our Provider Network Liaison at (877) 230-7571. n/a
Health Care Claim Status (for claims accepted for adjudication)
276/277

Companion Guide 

276 EDI Setup Form 
Provider Portal
Claim Status (for claims accepted for adjudication) can be confirmed real-time through our Provider Portal. Please visit Tools & Resources for additional information on the Provider Portal. To enroll please contact our Provider Network Liaison at (877) 230-7571.
n/a
Health Care Claim Acknowledgment (for claims accepted or rejected for adjudication) 277CA Companion Guide  277CA EDI Setup Form 
Confirmation Reports Portal Health Care Claim Acknowledgment (for claims accepted or rejected for adjudication) can be confirmed through our Confirmation Reports Portal. Please visit Tools & Resources for additional information on the Confirmation Reports Portal. To enroll please contact our Provider Network Liaison at (877) 230-7571. n/a
Benefit Enrollment and Maintenance 834 Companion Guide 
Health Care Claim Payment/Advice 835

Companion Guide
 
Enroll with Change Healthcare ePayment Services at (866) 506-2830 or online at Change HealthCare.

n/a
Health Care Claim
Institutional & Professional
837 Companion Guide 
Portal
Claims can be submitted electronically through a portal by manually keying in the claim information. This is an alternative to either of the electronic 837 or paper claim submission methods. Please contact Smart Data Solutions at (855) 297-4436 to get access to the Portal.
n/a

Getting Started with Electronic Data Interchange (EDI)
Trading partners interested in submitting electronic transactions can download and complete an EDI set up form. Complete the form and e-mail or fax to the EDI team at (608) 252-0893.

Scheduled Downtime 
  • Third weekend of every month
    • 10 pm Saturday to 11 am Sunday – vendor monthly systems maintenance. Can result in intermittent outages for real-time transactions related to Medicare Advantage plans.
    • 6 pm Sunday to 2 am Monday – Prevea360 systems maintenance. Will affect all real-time transactions.
  • Fourth weekend of every month
    • 8 pm Saturday to 2 am Sunday – vendor monthly systems maintenance. Will affect all real-time transactions.