| Getting Started with Electronic Claim Filing in Five Easy Steps Making the decision to send your healthcare claims electronically puts you only five steps away from all the benefits EDI has to offer. Follow the five easy steps below to get started with EDI for your business. Staff at the WPS EDI department are here to help with the process, just a phone call away at 800-782-2680, or email us at edi@wpsic.com. Step 1: Choose your claim filing option To submit claims electronically you may need:
Step 1: Claim Filing Options
Step 2: Submission Methods
Step 3: WPS Trading Partner System (WTPS) Registration WTPS is a self registration process for those who will be sending files directly to WPS (rather than through a clearinghouse/billing service). WTPS allows you to register for the lines of business you will be trading with, as well as the various transactions. WTPS will also assign your EDI submitter number to you on the spot. Step 4: EDI Agreement Before submitting your claims electronically you must sign a provider agreement form and return the original or fax a copy of the form to the EDI department. If you have elected to use a clearinghouse to submit your claims, you will still need to complete the EDI provider agreement. Once we have processed your form, we will contact you and your clearinghouse/billing service (if this is a chosen option) with approval to begin submitting test or production files. It is normally not required to test when submitting through an approved clearinghouse. These forms can be found on this page or within WTPS. Step 5: Testing Once your agreement is processed you will receive an EDI submitter number, password and either Bulletin Board System (BBS) instructions or Secure-EDI instructions based on the submission method you chose. You are now ready to test. To prepare your test file, please refer to the appropriate WPS HIPAA Companion Document. You will need to submit a test file of at least twenty-five (25) claims that are applicable to your practice (i.e., office visits, x-rays, lab work), so we can ensure your future production claims will process in an efficient manner. Once you have created your test file, you can submit through your chosen submission method. There is no need to notify our office that you are sending a test file. When your test file has been submitted through either WPS Secure-EDI or the WPS Bulletin Board System (BBS) we will telephone or email your office with the results of your test and either approve claim files for production, or request that you make any necessary modifications to your data and submit another test file. We will make every effort to contact you with your test results within 2 – 3 business days of your submission. To expedite your testing WPS strongly encourages you to use the WPS EDI Testing Portal Register for the WPS EDI Testing Portal online. Once you have registered, within one business day you will receive an email confirmation that contains the web address to access the site along with your username and password. The WPS EDI Testing Portal provides around the clock self-testing capabilities to prepare you for HIPAA compliant electronic exchanges with WPS. When submitting your test data online, you will receive test results within a matter of minutes. Files that pass the test will be certified as HIPAA compliant. To prepare your test file, please refer to the appropriate WPS HIPAA Companion Document. After your file is certified as HIPAA compliant, WPS will conduct further tests for compatibility within our claims processing system. Our Electronic Data Services staff will review your file and forward it to this final testing step. Within 2 – 3 business days you will receive an email approving you to submit electronic claim files for production or requesting that you make any necessary modifications to your data and submit an additional test file. You may send your first production file immediately upon approval. |
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