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DME MAC SPECIFICATIONS



Claims (837 transaction)    Top

Jurisdiction B DME MAC claims must be submitted using the HIPAA compliant ANSI 4010A1 X12N 837 transaction. This implementation guide is available at the Washington Publishing Company web site: www.wpc-edi.com*

Title Posted/Revised Date Description
837 Companion Document 01/08 Companion Document to the HIPAA ANSI X12N 837 implementation guide. Used for clarification purposes.
837 DME MAC Supplemental Guide 06/07 Provides DME MAC specific requirements and should be used in conjunction with the ANSI X12N 837 implementation guide.
837 Trading Partner Agreement 06/06 Provides information to the Trading Partner that will simplify implementation and provide a successful transition. Use for clarification purposes.

Remittances (835 transaction)   Top

Jurisdiction B DME MAC remittances are sent using the HIPAA compliant ANSI 4010A1 X12N 835 transaction. This implementation guide is available at the Washington Publishing Company web site: www.wpc-edi.com*

Title Posted/Revised Date Description
835 Companion Document 01/08 Companion Document to the HIPAA ANSI X12N 835 implementation guide. Used for clarification purposes.
835 Trading Partner Agreement 06/06 Provides information to the Trading Partner that will simplify implementation and provide a successful transition. Use for clarification purposes.

Claim Status Inquiry (276/277 transaction)   Top

Jurisdiction B DME MAC batch claim status inquiry must be submitted and received using the HIPAA compliant ANSI 4010A1 X12N 276/277 transaction. This implementation guide is available at the Washington Publishing Company web site: www.wpc-edi.com*

Title Posted/Revised Date Description
276/277 Companion Document 01/08 Companion Document to the HIPAA ANSI X12N 276/277 implementation guide. Used for clarification purposes
276/277 Trading Partner Agreement 06/06 Provides information to the Trading Partner that will simplify implementation and provide a successful transition. Use for clarification purposes.

Eligibility (270/271 transaction)   Top

The 270/271 transactions are handled through CMS. For more information, visit their web site using the following link: http://www.cms.hhs.gov/AccesstoDataApplication/*


NCPDP   Top

Jurisdiction B DME MAC retail pharmacy drug claims must be submitted using the National Council for Prescription Drugs Program (NCPDP). This implementation guide is available at www.ncpdp.org*

Title Posted/Revised Date Description
NCPDP Companion Document 01/08 Companion Document to NCPDP implementation guide. Used for clarification purposes.

Communications   Top
Title Posted/Revised Date Description
FTP Direct Dial-Up Access 11/03 File Transfer Protocol (FTP) for Windows 95, 98, 2000, NT or Windows XP Dial-up Networking.
MedAComm   Communication software available to download electronic Front-End reports and ERAs from AdminaStar Federal.
ProCom Plus 3.2   ProCom Plus 3.2 for Windows 95, 98 & NT
ProCom Plus 3.0   ProCom Plus 3.0 for Windows 95, 98 & NT
Technical Reference Manual 04/07 Technical Reference Guide for communications through the Wellpoint Enterprise Gateway for AdminaStar Federal EDI.
Zmodem Communications   Zmodem Communications for DME MAC, contains scripts for transmitting your DME MAC claims using ZMODEM protocol.


 

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