Wisconsin Chronic
Disease Program
Companion Document to
HIPAA Implementation
Guide: 837 Institutional
Printer-friendly version
(PDF, 45kb)
Companion Document Audience
Companion documents are intended
for information technology and/or systems staff who will be coding
billing systems or software for compliance with the federal Health
Insurance Portability and Accountability Act of 1996 (HIPAA).
Purpose of Companion Documents
The information contained in this
companion document applies to Wisconsin Chronic Disease Program (WCDP).
The companion documents are
designed to be used with HIPAA Implementation Guides. Companion
documents provide WCDP-specific information that details the way to
create HIPAA transactions for WCDP an explains how WCDP creates HIPAA
transaction. Companion documents clarify the HIPAA-designated
standards usage but are not intended to supercede them. The
purpose of companion documents is to provide trading partners with a
guide to communicate the WCDP-specific information required to successfully
exchange transactions electronically with WCDP.
WCDP will accept and process 837 Institutional
and Professional as well as NCPDP v5.1 -compliant transactions.
However, a compliant transaction that doesn't contain WCDP- specific
information, though processed, may be denied for payment. For
example, a compliant 837 Institutional claim created without a valid
WCDP covered diagnosis code will be processed by WCDP, but will be
denied payment. WCDP will not accept 837 Dental claims.
Please submit dental claims on paper.
Companion documents highlight the
data elements significant for WCDP. Please refer to the companion
document first if there is a question about how WCDP processes a HIPAA
transaction.
If your facility will be using the
PES software to submit claims to Wisconsin Medicaid, please be
aware this claim submission software is not compatible with the WCDP
system. The PES software provided by Wisconsin Medicaid does not
have the required fields needed to submit claims to WCDP.
For further information, contact
the Division of Health Care Financing (DHCF) Electronic Data Interchange
(EDI) Department at (608) 221-9036.
X12 837 Health Care Claim
Back to the HIPAA Home Page
Last Revised: May 24, 2004 |
