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Texas Insurance Carrier Or Trading Partner Medical Electronic Data Interchange (EDI) Profile

State:
Texas
Control #:
TX-EDI-02-WC
Format:
PDF
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Description

Insurance Carrier Or Trading Partner Medical Electronic Data Interchange (EDI) Profile Texas Insurance Carrier or Trading Partner Medical Electronic Data Interchange (EDI) Profile is a set of standards used by insurance companies and trading partners in Texas to exchange medical information efficiently and securely between the two. The Texas EDI profile is based on the American National Standards Institute (ANSI) X12 standards and is designed to facilitate the transmission of data between health plans, providers, and other entities involved in the healthcare industry. The profile includes a set of standard formats and rules for the exchange of information including medical claims, eligibility inquiries, payment information, and other administrative transactions. The Texas EDI Profile includes two different types of profiles, the Texas BCB STX EDI Profile and the Texas Medicaid EDI Profile. The Texas BCB STX EDI Profile is used primarily by insurance companies and trading partners in the commercial market and includes standard formats and rules for claims and eligibility information. The Texas Medicaid EDI Profile is used primarily by Medicaid providers and includes standard formats and rules for claims and eligibility information specific to Medicaid.

Texas Insurance Carrier or Trading Partner Medical Electronic Data Interchange (EDI) Profile is a set of standards used by insurance companies and trading partners in Texas to exchange medical information efficiently and securely between the two. The Texas EDI profile is based on the American National Standards Institute (ANSI) X12 standards and is designed to facilitate the transmission of data between health plans, providers, and other entities involved in the healthcare industry. The profile includes a set of standard formats and rules for the exchange of information including medical claims, eligibility inquiries, payment information, and other administrative transactions. The Texas EDI Profile includes two different types of profiles, the Texas BCB STX EDI Profile and the Texas Medicaid EDI Profile. The Texas BCB STX EDI Profile is used primarily by insurance companies and trading partners in the commercial market and includes standard formats and rules for claims and eligibility information. The Texas Medicaid EDI Profile is used primarily by Medicaid providers and includes standard formats and rules for claims and eligibility information specific to Medicaid.

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Texas Insurance Carrier Or Trading Partner Medical Electronic Data Interchange (EDI) Profile