HIPAA Transactions, Dean Health Plan

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HIPAA Transactions

Transaction companion guides

We support all HIPAA-compliant electronic transactions.

Transaction Transaction Number Companion Guide/Help Materials EDI Setup Form

Health Care Eligibility Benefit Inquiry and Response

270/271 EDI Companion Guide 270 EDI
Setup Form
Provider Portal Benefits Eligibility can be confirmed real-time through our Provider Portal. Please visit Provider Resources for additional information on the Provider Portal and to find your Provider Network Liaison who can help you enroll. n/a

Health Care Claim Status (for claims accepted for adjudication)

276/277 EDI Companion Guide 276 EDI
Setup Form
Provider Portal Claim Status (for claims accepted for adjudication) can be confirmed real-time through our Provider Portal. Please visit Provider Resources for additional information on the Provider Portal and to find your Provider Network Liaison who can help you enroll. n/a

Health Care Claim Acknowledgment (for claims accepted or rejected for adjudication)

277CA EDI Companion Guide 277CA EDI
Setup Form
Confirmation Reports Portal Health Care Claim Acknowledgment (for claims accepted or rejected for adjudication) can be confirmed through our Confirmation Reports Portal. Please visit Provider Resources for additional information on the Confirmation Reports Portal and to find your Provider Network Liaison who can help you enroll. n/a

Benefit Enrollment and Maintenance

834 Companion Guide 834 EDI
Setup Form
Health Care Claim Payment/Advice 835 Companion Guide
Enroll with Change Healthcare ePayment Services at (866) 506-2830 or online at Change HealthCare.
n/a

Health Care Claim Institutional & Professional

837 Companion Guide 837 EDI
Setup Form
Portal Claims can be submitted electronically through a portal by manually keying in the claim information. This is an alternative to either of the electronic 837 or paper claim submission methods. Please contact Smart Data Solutions at (855) 297-4436 to get access to the Portal. n/a

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 (608) 252-0893.

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

Transaction testing process

DHP will test all trading partner transactions prior to moving into a production environment. Below are 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.

HIPAA information

Centers for Medicare and Medicaid Services
Washington Publishing Company
Workgroup for Electronic Data Interchange

Scheduled downtime

Third weekend of every month

  • 10 pm Saturday to 11 am Sunday – vendor monthly systems maintenance. Can result in intermittent outages for real-time transactions related to Medicare Advantage plans.
  • 6 pm Sunday to 2 am Monday - Dean Health Plan monthly systems maintenance. Will affect all real-time transactions.

Fourth weekend of every month

  • 8 pm Saturday to 2 am Sunday – vendor monthly systems maintenance. Will affect all real-time transactions.

Contact us

If you have any questions, contact the DHP EDI team at dhpedi@deancare.com or (800) 356-7344, extension 4320.

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