Company Setup

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The HIPAA Eligibility Status Responder needs information about the Sender of EDI transactions so that the software can create a valid EDI file.

 

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

CompanySetup

The Company Setup window

 

Fill in the information as far as you know it.

Name and Address are self explanatory
The ISA identifiers are needed create the outer EDI envelope, the ISA segment.  If you don't already have an EDI identifier, choose it careful. It should be unique and easily identify your organization. You can use any name there with 15 character or less and use the qualifier 'ZZ' or choose another qualifier from a list below. Your company might already have a Duns ID or any other of those ID's.
o01                Duns (Dun & Bradstreet)
o14                Duns Plus Suffix
o20                Health Industry Number (HIN)
o27                Carrier Identification Number as assigned by Health Care Financing Administration (HCFA)
o28                Fiscal Intermediary Identification Number as assigned by Health Care Financing Administration (HCFA)
o29                Medicare Provider and Supplier Identification Number as assigned by Health Care Financing Administration (HCFA)
o30                U.S. Federal Tax Identification Number
o33                National Association of Insurance Commissioners Company Code (NAIC)
oZZ                Mutually Defined
Application Sender's Code is the information that goes into the GS_02 element. You can repeat your ISA identifier here or if your company has different EDI processes, put HIPELIGRSP to identify the HIPAA eligibility responder as originator
Tax ID is a required field and represents your companies tax payer ID
In order to uniquely identify your files it is helpful to prepend a three letter code in front of the filename
Entity Type code holds information that goes into the NM1_01 of the 2100 loop and classifies your business. There are 5 different choices to make
oThird Party Administrator
oEmployer
oGateway Provider
oSponsor
oPayer
Contact information again is self explanatory.
ISA 14 specifies whether your files are Test of Production files
Acknowledgement requested means that you expect a TA1 Acknowledgement in response to your file. Normally you would not.