FAQs - EDI
The questions below pertain to providers and Electronic Data
Interchange (EDI) vendors that send and receive data electronically
using a software developer, clearinghouse, or billing service.
Providers using Web interChange should view the FAQs on the Web interChange
How do I obtain a trading partner ID?
EDI Vendors: To obtain a trading partner
identification (ID) for testing, follow the directions in Software Testing
Providers: View Trading Partner
Registration Procedure for step-by-step instructions for
becoming a trading partner with the Indiana Health Coverage
How long does it take to receive my login information?
EDI Vendors: After HP receives the IHCP Trading
Partner Profile, the HP EDI Unit assigns and sends test IDs within
five business days.
Providers: Once your software vendor is
approved for production, and a signed Trading Partner Agreement is
received, the HP EDI Unit assigns and sends production IDs within
five business days.
How do I get set up for the 835 transaction? I am already set
up for 837.
To get set up for the 835 transaction, submit the EDI
Outbound Transactions Request Form. Your provider number will
be linked to the appropriate trading partner ID to receive the 835.
Allow five business days for this setup.
If I submit my claims via a clearinghouse or software vendor,
how long does it take to see them on Claim Inquiry within Web
All claims submitted electronically, either via a clearinghouse,
vendor, or Web interChange, are viewable in claims inquiry after
two hours if the claim is submitted between 8 a.m. and 5 p.m.
Claims submitted after 5 p.m. are viewable after 8 a.m. the next
Do you have information about testing HIPAA 5010 and NCPDP
EDI Vendor: For information regarding Health
Insurance Portability and Accountability Act (HIPAA) 5010 and the
National Council for Prescription Drug Programs (NCPDP) D.0,
see What's New for EDI Vendors
and the HIPAA 5010
and NCPDP D.0 FAQs.
Providers: View HIPAA 5010 and NCPDP D.0 FAQs for
information regarding HIPAA 5010 and NCPDP D.0.
On what segment and loop are the group provider number and
rendering provider number located within the 837P?
In the 837P transaction, the billing provider number is located
in loop 2010A within segment REF02. The rendering provider number
is located in loop 2310B within segment REF02. View the IHCP Companion
Guides for more information.
On what segment and loop are the referring provider and
certification code located within the 837P?
In the 837P transaction, the referring provider is located in
loop 2310A within segment REF02. This segment contains either the
nine-digit provider number of the primary medical provider (PMP) or
the IHCP provider number of the case manager for Waiver claims. The
two-digit PMP certification code is located in loop 2300 within
segment REF02. See the IHCP Companion Guides
for more information.
Why are there discrepancies when I compare the Web interChange
RA with the 835 transaction?
For clarification, the Web interChange Remittance Advice (RA)
reports only dollar amounts without balancing concerns. This dollar
amount reflects prior payment information including spend-down,
third party liability (TPL), and Medicare payments; or Medicare
co-insurance or deductible as submitted with the original claim.
For a technical example of the IHCP 835 transaction adjustment
information related to the balancing methodology identified in the
4050 draft version of the 835 guide, please review Electronic
835/Web interChange RA Comparison.