Receivers

Clients of CorVel that receive transactions from submitters for adjudication

Frequently Asked Questions (FAQ)

What is my company’s PAYOR ID?

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Where should PROVIDERS go to get setup for EDI submission?

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Where should VENDORS go if they want to get setup to send us EDI?

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Is my company COMPLIANT with all state jurisdictional EDI mandates?

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What is CorVel doing to help REDUCE MY PAPER submissions?

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Can CorVel help me with ELECTRONIC PAYMENTS to my providers?

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What OTHER SERVICES does CorVel offer to help my company?

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HIPAA X12:

  • 837 (Bills: D, P, I & Rx)  (4010A1 & 5010)
    NCPDP (Rx)
  • 275 Patient Information Attachment
  • 997 & 999 Syntax Validation
  • 824 Standards and Jurisdiction* Validation
  • 276/277 (Claims Status)
  • 277U (Unsolicited Claims Status)
  • 835 (Remittance Advice)
  • 278 (Referrals & Prior Authorizations)
  • 820 (Premium Payements)
  • 834 (Enrollment & Disenrollment)

    o  Payor specific validations
    o  Claims aggregation from any source & vendors
    o  BPO: Paper to EDI conversion Services
    o  BPO: Bill / Claims Printing Services
    o  Proprietary formats (to & from clients / partners)
    o  Proprietary EOBs , reports, communications
    o  Proprietary rejection reports

Formats Supported

  • ANSI X12 837
  • NSF (multiple versions)
  • Print Image
  • Industry Standard
  • WorkCompEDI Proprietary
  • Client Proprietary
  • XML
  • HL7

Pre-Adjudication Validation & Scrubbing

  • Claim Files
  • Vendor Files
  • Provider Files
  • Taxonomy Codes
  • State License Numbers

Advanced Transactions

  • Proof of Services (POS)
  • Secondary Party Serving (SPS)
  • Direct to Mail (DTM)
  • Claim Index Look-up
  • OCR / Paper-to-EDI
  • EOB-to-EDI
  • Custom Printing & Fulfillment

Bill file generated

  • 837, print image, proprietary, etc.

Attachments indexed

  • PWK, scan/fax with cover sheet/bard code, etc.

Receiving party generates acknowledgement response

  • 997/999/Ack

Receiving party generates bill level notifications/rejections & final remittance

  • 277/824/835

If using clearinghouse, bill level notifications will come from clearinghouse first, then Payor or Bill Review company

Transmission Methods

  • sFTP (File Transfer)
  • HTTPS (web upload)
  • API

PDF

TIFF & JPEG

Formats Accepted

  • 275 X12 Format (5010 & 6020)
  • PDF
  • TIFF / JPEG / GIF
  • Other Image Formats
  • Submitting attachments before bills or after, as single images or in bulk, independent of a bill (directly from an EMR/document management system) or indexed by a practice billing system.
  • Able to match bills to images submitted using numerous indexing protocols, which provides an easy way to search and share supporting documents.
  • If providers are required to submit specific attachments for a bill, our tools give submitters the ability to classify the type of attachments they are submitting, further helping ensure a “clean submission”.
  • COMING SOON: Orphan attachment submission processes