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HIPAA Transactions  

Transaction Companion Guides

We support all HIPAA compliant electronic transactions.

The Claim Adjustment Reason Codes will be updated quarterly. To ensure you are referencing the correct reason codes, please download the file on a quarterly basis and discard all earlier documents.

Transaction Transaction Number Companion Guide
Health Care Claim Institutional
& Professional		 837 Companion Guide
Health Care Payment/Advice 835 Companion Guide
Health Care Eligibility/Benefit Inquiry 
& Response		 270/271 Companion Guide
Health Care Claim Status Request
& Response		 276/277 Companion Guide
Benefit Enrollment and Maintenance 834 Companion Guide

 

Steps for Getting Started with Electronic Data Interchange (EDI)

Trading partners interested in submitting electronic transactions to DHP can download and complete an EDI set up form. Please complete the form and e-mail or fax to the DHP EDI team (800) 356-7344 Ext.: 4320.

Trading partners can also call (800) 356-7344 Ext.: 4320 to request an EDI set up form.

EDI set up Form - PDF

EDI set up Form - Word Doc

Transaction Testing Process

DHP will test all trading partner transactions prior to moving into a production environment. Below, please find the steps DHP will take when testing a transaction.

  1. Create test folder on FTP server for trading partner
  2. Test trading partner files with Claredi® to ensure that transactions are valid.
  3. Work with trading partner to eliminate all Claredi® identified errors 
  4. Process transaction in test environment to ensure accurate results 
  5. Set up production folder for trading partner on FTP Server.