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WPS Insurance Corporation is the Medicare Part B Carrier for the states of Illinois, Michigan, Minnesota and Wisconsin.
Health Care Claim Status Request and Response
Wisconsin Physicians Service (WPS) has added a 276/277 (Health Care Claim Status Request and Response) request
form (PDF) to the EDI Forms Web Site.
- The 276 Transaction is an electronic request for the current status of a claim within
the adjudication process. This can be requested at the claim and/or line level.
- The 277 Transaction is an electronic response to the 276 request.
This Transaction is a Batch process and requires the requester to have access to the Bulletin
Board System. Request
a Submitter ID. The Implementation Guide for this Transaction Set (276/277) is located
at www.wpc-edi.com.
Accessing the Medicare Part B Web
Site Just Got Easier
WPS Medicare is always looking for ways to make it easier for you
to access Medicare information. As part of that effort, effective
May 1, 2005, the new Medicare Part B Web site address is www.wpsmedicare.com.
This address will take you directly to the WPS Medicare Website.
The old address will stay in effect indefinitely, but it is a good
idea to change your bookmarks.
Claims
The Health Insurance Portability and Accountability Act (HIPAA)
requires that health insurance payers in the United States, comply
with the EDI standards for health care as established by the Secretary
of Health and Human Services. The ANSI X12N 837 implementation guides
have been established as the standard for compliance for claim transactions.
The implementation guides for the 837 professional and institutional
are available electronically at http://www.wpc-edi.com/hipaa/HIPAA_40.asp.
Remittance
Electronic Remittance Advice (ERA) is an electronic version of
your Explanation of Benefits and allows you to automatically post
your accounts.
The implementation guide for the 835 is available at http://www.wpc-edi.com/hipaa/HIPAA_40.asp.
Eligibility Request & Response Flat
File Specs for Providers
The implementation guide for the eligibility 270/271 is available
at http://www.wpc-edi.com/hipaa/HIPAA_40.asp.
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