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EDI Questions & Answers

What is the position of the Rendering Provider Network ID field?

 

Must I enter Providers ID number in block 33?

 

How soon will you receive my claims?

 

When will I receive my payment?

 

How do I begin to do EDI billing with your company?

 

What is your Payer ID Number?

 

I received a rejection report stating "Invalid Provider ID prevents Carrier from processing." What does it mean?

 

835 (Remittance Advice) Companion Document

 

What is the position of the Rendering Provider Network ID field?
According to Envoy proprietary format the Rendering Provider Network ID is in the following location:
a) if filing for hospital charges (UB 92) - 46:12
b) if filling Medical charges (HCFA 1500) - E6:14

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Must I enter Providers ID number in block 33?
Every software is different and mapped differently. Please contact your software vendor for the location.

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How soon will you receive my claims?
We receive claims within 24 to 48 hours from WebMD.

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When will I receive my payment?
Usually it takes approximately 2 weeks or less for the payment to be processed.

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How do I begin to do EDI billing with your company?
In order to bill Keystone Mercy Health Plan electronically, you will need to contact your vendor and/or clearinghouse to request for our payer ID be added to your list of payers. This should be sufficient to get you started. If you have any questions or experience problems you can contact our EDI technical support hotline: 877-234-4271, press 4 , or you can email us at Edi.kmhp@kmhp.com.

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What is your payer ID number?
Our payer ID number is 23284.

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I received a rejection report stating "Invalid Provider ID prevents Carrier from processing." What does it mean?
This message is issued whenever Rendering Provider Network ID field on the electronic claim is populated with incorrect information. The field should only be populated with the Provider's Individual ID number assigned by the Plan. Provider ID numbers maybe validated by contacting Provider Services at 800-521-6007.

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