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 Transactions 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.

 

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

 

About the Firm
Administrative Services
IT & Home Office Support
Meet Senior Management
Meet the Staff
Meet the TPA Founders
Jobs at Wakely
HIPAA Status
Contact Wakely
About the Firm
Administrative Services
IT & Home Office Support
Meet Senior Management
Meet the Staff
Meet the TPA Founders
Jobs at Wakely
HIPAA Status
Contact Wakely
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