For easy reference BHT is collecting Companion Guides from each of the managed care organizations (MCOs) in our region onto this page. They will be listed here in aphabetical order as we receive them. Stay tuned for more updates.
Amerigroup
Click here to view the most recent version of Amerigroup’s EDI Companion Guide.
Community Health Plan of Washington (CHPW)
For Providers (not the BHASO’s), CHPW strictly follows the 837 Healthcare Claim Professional and Institutional Guide (IG) version 5010, SERI for substance use disorder providers, and the HCA guidelines. Because we follow these we do not have CHPW specific companion guides.
- The 837 Healthcare Claim Professional Guide (IG) version 5010 can be found at www.wpc-edi.com or by calling (425) 562-2245.
- Service Encounter Reporting Instructions (SERI) https://www.hca.wa.gov/billers-providers-partners/behavioral-health-recovery/service-encounter-reporting-instructions-seri
- The HCA guidelines are at https://www.hca.wa.gov/billers-providers-partners/prior-authorization-claims-and-billing/hipaa-electronic-data-interchange-edi.
The acknowledgement files (999/277CA) are discussed in the 837 transaction companion guide.
For the BHASO’s we also have the below encounter information in addition to the above:
- 837 Encounter Data Companion Guide from State of Washington https://www.hca.wa.gov/billers-providers-partners/prior-authorization-claims-and-billing/hipaa-electronic-data-interchange-edi.
- Encounter Data Reporting Guide from State of Washington https://www.hca.wa.gov/billers-providers-partners/prior-authorization-claims-and-billing/hipaa-electronic-data-interchange-edi.
Molina Healthcare
Click here to view the most recent version of Molina’s EDI Companion Guide, which can also be found on their website along with other useful information under the EDI ERA/EFT link.
