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Trading Partner Registration Procedure |
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The Health Insurance Portability and Accountability Act
(HIPAA)
requires that all healthcare organizations
exchanging HIPAA transaction data electronically with the Indiana Health Coverage Programs
(IHCP) establish an Electronic Data Interchange (EDI) relationship. Entities with
this EDI relationship are referred to as trading partners. The IHCP has prepared the
following information to assist entities with becoming an IHCP trading partner.
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Providers who are NOT required to become an IHCP Trading Partner
Billing providers, who exchange data with IHCP exclusively using the following methods,
do NOT need to become an IHCP trading partner:
IHCP Clearinghouse
IHCP Billing Service
IHCP VAN
Web interChange
Automated Voice Response (AVR)
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Providers must use an IHCP software vendor, billing
service, clearinghouse, or VAN to exchange data. Providers must review the
IHCP-approved software developers to ensure that their vendor has been approved.
There is no affiliation between the IHCP and any of the companies on the approved vendor
list. It is the responsibility of the provider to select a vendor based on specific
business needs.
Providers developing their own software must follow the
Software Testing Procedures prior to becoming a trading partner.
Billing providers who directly exchange data electronically with IHCP must become an IHCP
trading partner by completing the following:
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1. Complete a Trading Partner Profile
The IHCP requires billing providers exchanging data directly with the IHCP to complete and
submit the
IHCP Trading Partner Profile to initiate the
process for becoming a Trading Partner. The IHCP Trading Partner Profile is the tool
the provider must use to notify the IHCP about the types of transactions they will
exchange and the software they will use.
The IHCP Trading Partner
Profile is also used to inform the IHCP of any changes to their vendor software, billing
service, or clearinghouse selection.
2. Complete a Trading Partner Agreement
The
IHCP Trading Partner Agreement is a contract between parties who have chosen to become
electronic business partners. The Trading Partner Agreement stipulates the general
terms and conditions under which the partners agree to exchange information electronically.
If billing providers send multiple transaction types electronically, only one signed
Trading Partner Agreement is required. Billing providers must print and
complete a copy of the Trading Partner Agreement. It must be printed, signed, and
mailed to the following address:
EDS
Trading Partner Agreement
950 North Meridian Street
10th Floor
Indianapolis, IN 46204
Upon receiving the IHCP Trading Partner Profile form and the signed IHCP Trading Partner
Agreement, the billing provider will be evaluated for exchanging production data.
The trading partner will receive written notification of approval.
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