Med-QUEST Logo  

Overview
MQD HIPAA Activity
Providers
Health Plans
Government Providers
Software Developers
News and Events
Documents and Deliverables
Helpful Links
Frequently Asked Questions
Glossary of Terms
837/835 Testing
 
Contact Us
Downloadable Forms

 

Thanks for testing with us! Med-Quest and the ACS EDI Team welcome you to the 837/835 testing page.

This page contains information on registering for Electronic Data Interchange (EDI), preparing for 837/835 testing, conducting testing, and completing the testing process. Trading partners - Med-QUEST providers and their vendors, clearinghouses, or billing services - are encouraged to review the site to learn more about the testing process.

ACS, the Med-QUEST fiscal agent, is responsible for assisting providers and vendors with EDI-related issues. The ACS Provider Call Center is staffed from 7:30 a.m. until 5:00 p.m. (Hawaii Standard Time), Monday through Friday. They can be reached at the following numbers:

(808) 952-5570 - Oahu and Mainland
(800) 235-4378 - Neighbor Islands

The ACS EDI Team can also be reached via e-mail at hi.ecstest@acs-inc.com

Download the Following Documents

  1. DHS Medicaid EDI Manual
  2. Example of 835 File
  3. Example of 835 Supplementary File
  4. HI 835 RA Companion Doc V1.4
  5. HI 835 RA Change Summary V1.4
  6. HI 837 Claims Companion Doc V1.5
  7. HI 837 Claims Change Summary V1.5
  8. Submitter Status as of 04/07/04

Contact us
Hawaii providers often have complex, varied relationships with billing agents, Medical Managers, software vendors, clearinghouses, and in-house Information Technology (IT) personnel. The ACS EDI Team must clearly and completely understand these relationships. This will help us ensure we communicate effectively and efficiently.

Register with ACS
EDI with Med-QUEST requires sign-up and assignment of User IDs and passwords. Trading partners should contact ACS to begin the registration process. ACS will gather some basic information and distribute the DHS Medicaid EDI Manual. The DHS Medicaid EDI Manual will contain detailed instructions for registering, preparing for testing, and other important information.

If you are a provider, billing agent, or medical manager – We need to know who you call if you encounter a problem with your billing software. Is the person internal to your company? If so, who does he or she contact? It is vitally important that we understand who is developing your billing software for you. The ACS EDI Team will be happy to keep you fully informed of testing progress, but we need to be sure we’re talking to all the right people.

If you are a vendor, clearinghouse, or software developer – we need to know about your providers. We also need to understand any subcontractor arrangements. It is not uncommon for local IT shops to work with a national vendor, or for one software company to contract with a clearinghouse. In some cases, providers may not be fully aware of these arrangements. To avoid confusion and incorrect/inefficient communication, we need to know who the players are. We also need to know if you handle only one type of transaction (for instance, professional rather than institutional claims), and who the contacts for other transactions may be.

Demonstrate your Ability to Submit a Certified Transaction
The ACS EDI Team requires all trading partners to demonstrate their ability to submit a certified transaction prior to beginning testing. The transaction must be certified to Level IV (4).

Why must I certify? TCS testing can be very complicated. Certifying your transactions prior to testing with Med-QUEST dramatically shortens the time it takes to complete testing.

What does Level IV mean? Med-QUEST requires demonstration of certification to Level 4 for all inbound transactions, where T1 = syntactical integrity; T2 = Implementation Guide; T3 = Balancing; and T4 = Inter-segment Data Relationships.

How can I get certified? Your software developer will send test transactions to a qualified certification entity. Below is a partial list of certifying agencies. Please be aware that Med-QUEST does not recommend one agency over another, nor do we require trading partners to use a particular certification entity.
www.hipaatesting.com
www.edifecs.com
www.claredi.com

How can I demonstrate certification? Trading partners can use any of the following methods to demonstrate certification:· Response from certification entity indicating an 837 transaction has successfully passed Level IV certification· Verification the trading partner is currently in production with at least one other payer· Other – please email hi.ecstest@acs-inc.com.

ELIGIBILITY | PROVIDERS | HIPAA | CONTRACTORS/VENDORS
NEWS AND EVENTS | FREQUENTLY ASKED QUESTIONS | FORMS | CONTACT US
 

© Hawaii State Med-QUEST Division, 2003