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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:
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. |
| o | 01 Duns (Dun & Bradstreet) |
| o | 20 Health Industry Number (HIN) |
| o | 27 Carrier Identification Number as assigned by Health Care Financing Administration (HCFA) |
| o | 28 Fiscal Intermediary Identification Number as assigned by Health Care Financing Administration (HCFA) |
| o | 29 Medicare Provider and Supplier Identification Number as assigned by Health Care Financing Administration (HCFA) |
| o | 30 U.S. Federal Tax Identification Number |
| o | 33 National Association of Insurance Commissioners Company Code (NAIC) |
| • | 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 |
| o | Third Party Administrator |
| • | 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. |
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