Navigation Path: [Trading Partner] - [EDI]

This page includes the following panels:

• EDI Software: This table provides free software for the submission of eligibility verification and claim transactions. The software is called "Provider Electronic Solutions" and can be downloaded or ordered on CD by calling the EDI Department at the Gainwell Technologies Provider Assistance Center.

  The software can be installed or upgraded to the latest software version. Instructions prior to proceeding, for installing, and for different operating systems are provided. The links contained in the table navigate to .exe or PDF files that open in a new window for downloading.

• EDI Documents: This panel includes the following documents that electronic submitters should use for format and code set information:
  
  • Implementation Guides: Contains links to Implementation Guides that are based on the standards for HIPAA compliance. Click these links to navigate to other Web sites for further assistance.
  • Companion Guide: Provides a link to the "Companion Guide" that opens a PDF file in a new window; this can be downloaded. This PDF contains trading partner information. It includes a document that details information specific to the Connecticut Medical Assistance Program about what is required to successfully exchange electronic transactions with Gainwell Technologies in ASC X12 and NCPDP 5.1 standard formats. The information contained in these manuals is for both billing providers and technical staff.
  • Vendor Interface Specifications: Contains a link for downloading the Vendor Interface Specifications document, which provides information regarding telecommunication requirements. This document contains information required for software vendors to upload and download HIPAA compliant transactions with the Connecticut Medical Assistance Program.
  • Trading Partner Agreement: The submitter can view, print or save the Trading Partner Agreement with the application data as a PDF file.
  • Trading Partners Users Guide: Includes step-by-step instructions to login and exchange data with Connecticut Medical Assistance Program. The Guide can be downloaded as a PDF file by clicking the link.
  • EDI Specifications: Information pertaining to the Implementation Guide is provided, including the Web address for downloading the file. The Implementation Guide is designed to assist trading partners who submit claims and/or receive Electronic Remittance Advice (ERA) in the 835 format. If you would like to download the 835, make sure to update your Trading Partner Agreement.

• Required HIPAA EDI Testing:
• Claim Transactions: Explains the procedure for claim transactions; for example, which format a provider should use to transmit claims, or how a provider can download necessary documents like the Trading Partner Agreement and the Companion Guide in PDF format. After submitting documents to Gainwell Technologies, a provider receives a User/Trading Partner ID and initial password that they can use to submit their test file to the Secure Web site.
• Electronic Remittance Advice Transactions: To receive Electronic Remittance Advice transactions, providers and their software vendors should download the Trading Partner Agreement form in PDF format. After the document has been submitted, the provider receives a new Web User/Trading Partner ID and initial password. This can be used to access a test file that contains a recent remittance advice file that has been converted to the ASC X12N 835 Health Care Payment/Advice format.