MEDICAID
/ PRIMARY CARE NETWORK
The Division of Health Care Financing (HCF) manages multiple medical
programs for needy individuals in the State of Utah, including
Medicaid and the Primary Care Network (PCN) Program. Medicaid administers
these programs and encourages electronic data interchange (EDI)
as a means to contain administrative costs. This page describes
the process for activating your EDI account with Medicaid.
Whether providers are currently sending EDI transactions or wish
to start sending transactions, an EDI account must be activated
with Medicaid.
Providers must:
1. Become a member of the Utah Health Information Network (UHIN)
by
a. Signing UHIN's current Electronic Commerce Agreement, and
b. Obtaining a UHIN Trading Partner Number* (TPN).
2. Complete the Utah Medicaid Provider
EDI Enrollment application.
Providers have the responsibility to adequately test all business
rules appropriate to the provider type and specialty. When using
a third party vendor (clearinghouse), it is the obligation of
the trading partner* to ensure the vendor has adequately tested
the
business rules appropriate to each provider type and specialty.
*A provider submitting EDI transactions is considered a trading
partner.
|
