EDI Tools & Resources

Health Care Claim Status Request and Response

The 276/277 request form.

• 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 a WPS issued Submitter ID. Request a Submitter ID. The Implementation Guide for this Transaction Set (276/277) is located on the
Washington Publishing Company website.

On-line Claim Submission Through TRIWEST.com (for West Region providers only)

WPS is pleased to introduce Internet claim entry through TRIWEST.com - a comprehensive, secured website and your primary TRICARE information source for patient and claim data.
Select this link for more information.

Medicare EDI Gateway

The Medicare EDI Gateway allows for secure transfer of information for EDI trading partners via a Network Service Vendor (NSV) or over the secure AGNS network directly to WPS. All transfers via this network will connect to one server. A web browser-based interface provides our customers with an easy to use, graphical interface to assist in the upload and download of files. For users who would like to script their files transfers, an SSH FTP client will be required. An SSH Client is NOT provided or recommended by WPS. WPS does not provide technical support to SSH FTP users.
Read the Medicare EDI Gateway user guide for more information.

Password Requirements for the EDI Bulletin Board System and Medicare EDI Gateway

To meet WPS corporate and federal security mandates, the following password policies are in place:

• Minimum password length will now be 9 characters.
• Passwords must include one special character. Special characters are characters appearing on your keyboard that are neither alpha nor numeric.
• Passwords may not include dictionary words, names or user IDs.
• A minimum of 4 password characters must be changed whenever passwords are changed.
• Maximum password age will now be 60 days. WPS EDI systems will require a password change after 60 days.
• Account is locked after 3 unsuccessful login attempts within 60 minutes. The account will remain locked for 180 minutes.

If you have any questions regarding WPS EDI password requirements, please contact the EDI Help Desk:

Medicare J5 National Part A, MAC J5 and J8 (Parts A and B)
1-866-503-9670

Medicare Part B Wisconsin, Minnesota, Illinois
1-877-567-7261

TRICARE
1-800-782-2680

WPS commercial
1-800-782-2680

PC-Ace Pro32

PC-Ace Pro32 is a "stand alone" software package that creates a patient database and allows your office to electronically submit most WPS Commercial, Medicare Part B IL, MN, WI, J5 National Part A, MAC J5, MAC J8 and TRICARE claims electronically.

EDI Bulletin Board System

WPS is currently using the EDI Bulletin Board System (BBS) to receive your electronic claims using asynchronous telecommunications. The BBS also allows you to receive reports from WPS, view messages on various BBS forums, send email to WPS Electronic Data Services staff, and download documents pertaining to Electronic Data Interchange (EDI).

Electronic Remit Advice

ERA - WPS and TRICARE

• ERA - WPS Commercial: Input Sheet
• ERA - TRICARE: Input Sheet

ERA - Medicare

• Authorization form for Electronic Remittance Advise Processing (ERA)

Deactivation Request Medicare Part A/B

TRICARE Deactivation form

WPS Commercial Deactivation form

Electronic Funds Transfer

• Overview
• Complete Enrollment Package, EFT, Agreement & ERA
  WPS Commercial, EPIC, Family Care & HIRSP
• EFT Agreement - WPS Commercial
• Tricare for Life Electronic Funds Transfer (EFT)
• Complete Enrollment Package, EFT, Agreement & ERA - Tricare for Life
• Privacy Act Advisory
• EFT Presentation

Medicare Resources

• CMS EDI Registration Form
• NPI 1500 Crosswalk
• Network Service Vendor Agreement

TRICARE Resources

• TRICARE Regions at a Glance
• TRICARE Agreement
• TRICARE4u Agreement
• TRICARE for Life Provider Agreement
• Triwest Announcement

MREP and PCPrint Software

• PCPrint version 4.2.2
  You will need to go to your Control Panel and remove the previous version of PCPrint before installing the 4.2.2 version of the program.
  
  You may receive an error message when accessing Help if you are using Windows Vista or higher. If this occurs, please go to this Microsoft Support page and follow the directions. You will need a one-time-only download to correct the problem.



• Read an overview of Medicare Part B Remit Easy Print (MREP)
• Download the new MREP (Medicare Remit Easy Print) software here

EDI Connection

The EDI Connection lists contact information of all vendors, clearinghouses/billing services who have been approved with electronic claim filing with:

• WPS Commercial Insurance, EPIC, Family Care, and HIRSP
• Medicare
• TRICARE