| · | About the Firm |
| · | Administrative Services |
| · | IT & Home Office Support |
| · | Meet the Senior Management Team |
| · | Meet the Staff |
| · | Jobs at Wakely |
| · | HIPAA Status |
| · | Contact Wakely |
| · | Printer-Friendly Version |
HIPAA
Status
Wakely and Associates, Inc. is a third party administrator that administers Medicare Supplement benefits. At this time we are currently accepting standard (EDI) claim transactions from Medicare, and non-standard (paper) claims from providers and policyholders. We accept all HIPAA transactions indicated below, via a web-based gateway, directly from providers upon the complete implementation of the Transactions and Code Sets standards. We are not planning a relationship with clearinghouses for the collection and distribution of this information. However, we will continue to receive Medicare claims electronically from Medicare contractors, and therefore in most instances we will receive 837's without the need for you to submit them directly.
Listed
below are the HIPAA Transaction and Code Set Standards and our current
status regarding HIPAA compliant transactions. This information may also
be downloaded in Microsoft Word Format.
If you have any further questions or would like additional information,
please click here to send
an email regarding HIPAA issues.
Wakely and Associates, Inc. is a third party administrator that administers Medicare Supplement benefits. At this time we are currently accepting standard (EDI) claim transactions from Medicare, and non-standard (paper) claims from providers and policyholders. We accept all HIPAA transactions indicated below, via a web-based gateway, directly from providers upon the complete implementation of the Transactions and Code Sets standards. We are not planning a relationship with clearinghouses for the collection and distribution of this information. However, we will continue to receive Medicare claims electronically from Medicare contractors, and therefore in most instances we will receive 837's without the need for you to submit them directly.
| Transaction/Code
Set |
Currently
Supported |
| TRANSACTIONS |
|
| Eligibility/Benefit
Inquiry & Response (270/271) |
Yes |
| Claim
Rqst for Additional Info & Response (275/277) |
NA |
| Claim
Status Request & Response (276/277) |
Yes |
| Request
for Review & Response (278) |
NA |
| Premium
Payment (820) |
NA |
| Benefit
Enrollment & Maintenance (834) |
NA |
| Claim
Payment Advice (835) |
Yes |
| Claims
(Dental, UB92's, HCFA's) (837) |
Yes |
| MEDICAL
DATA CODE SETS |
|
| ICD-9
(1-3) |
Yes |
| NDC
(National Drug Code) |
No |
| CDT |
NA |
| HCPCS & CPT-4 |
Yes |
| NON-MEDICAL
DATA CODE SETS |
|
| Provider
Taxonomy |
No |
| Claim
Adjustment Reason Codes |
Yes |
| Claim
Status Codes |
Yes |
| Claim
Status Category Codes |
No |
| Decision
Reason Code |
Yes |
| Remittance
Advice Reason Code |
Yes |