Receivers

Clients of Medlogix that receive transactions from submitters for adjudication

Frequently Asked Questions (FAQ)

What is my company’s PAYOR ID?

This is the heading

Click edit button to change this text. Lorem ipsum dolor sit amet consectetur adipiscing elit dolor
Click Here

Where should PROVIDERS go to get setup for EDI submission?

This is the heading

Click edit button to change this text. Lorem ipsum dolor sit amet consectetur adipiscing elit dolor
Click Here

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

This is the heading

Click edit button to change this text. Lorem ipsum dolor sit amet consectetur adipiscing elit dolor
Click Here

Is my company COMPLIANT with all state jurisdictional EDI mandates?

This is the heading

Click edit button to change this text. Lorem ipsum dolor sit amet consectetur adipiscing elit dolor
Click Here

What is CorVel doing to help REDUCE MY PAPER submissions?

This is the heading

Click edit button to change this text. Lorem ipsum dolor sit amet consectetur adipiscing elit dolor
Click Here

Can CorVel help me with ELECTRONIC PAYMENTS to my providers?

This is the heading

Click edit button to change this text. Lorem ipsum dolor sit amet consectetur adipiscing elit dolor
Click Here

What OTHER SERVICES does CorVel offer to help my company?

This is the heading

Click edit button to change this text. Lorem ipsum dolor sit amet consectetur adipiscing elit dolor
Click Here

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