Company Setup

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The HIPAA Claim Status Responder needs certain information about you as the sender of EDI transactions so that the software can create a valid EDI file. This information will mainly go into the EDI envelope.

 

The menu item 'Setup --> Company Setup' will present you with the following screen:

CompanySetup

The company setup screen

 

Fill in the information as far as you know it.

Name and Address are self explanatory
The ISA identifiers are needed to create the outer EDI envelope, the ISA segment.  You can use any name there with 15 character or less and use the qualifier 'ZZ'.  Here a list with all the identifiers and qualifiers

 

01                Duns (Dun & Bradstreet)

14                Duns Plus Suffix

20                Health Industry Number (HIN)

27                Carrier Identification Number as assigned by Health Care Financing Administration (HCFA)

28                Fiscal Intermediary Identification Number as assigned by Health Care Financing Administration (HCFA)

29                Medicare Provider and Supplier Identification Number as assigned by Health Care Financing Administration (HCFA)

30                U.S. Federal Tax Identification Number

33                National Association of Insurance Commissioners Company Code (NAIC)

ZZ                Mutually Defined

Application Sender's Code is needed for the Group Start segment GS, the second envelope of any EDI transaction. You can repeat here the entry from the ISA sender identifier.
Tax ID, this is self explanatory
Plan ID or Payor ID, this information goes into the 277 response file and is the Payer ID for the NM1_09 element in the loop 2100A. Choose Payer ID
The optional 3 letter identifier to prepend your file names makes it easier for your trading partners to identify your responses as coming from you. This is not a mandatory field
Entity Type code holds information that goes into the NM1_01 of the 2100 loop and classifies your business. There are about 50 different values to choose from. Select the one that describes your business the closest. This value is also used in STC_01-3, the entity identifier in the status segment. This segment is not mandatory and can be omitted.
Contact information again is self explanatory.
The last block of data is again concerned with the first segment of any EDI file, the ISA segment. ISA element 14 determines whether your response is Test or Production data, and ISA 15 indicates whether you expect to receive an  acknowledgment for receipt for your files, the so called TA1 transaction.