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EDI Transactions

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires covered entities (healthcare plans, payers, providers and clearinghouses) to conduct electronic healthcare transactions in a standard format. The federal government has issued rules to implement HIPAA, including the Transaction Rule, which mandates the specific format for certain electronic transactions.

Click on one of our Quick Tip Guides for more information releated to payer ID, edits, and troubleshooting ideas.

Availity
Emdeon (formerly WebMD)
VISTA


This companion guide is intended for the business and technical areas, within or on behalf of a provider organization, responsible for conducting electronic transactions with VISTA Healthplan, Inc., and VISTA Healthplan of South Florida, Inc. ("VISTA"). This information should be communicated to and coordinated with the provider's billing office in order to ensure that the required billing information is provided to its billing agent/submitter. This information is intended to serve only as a companion to the HIPAA XML X12N Implementation Guides, as well as to be used in conjunction with the clearinghouse Companion Guides for those clearinghouses listed below.

Interested in implementing EDI transactions with VISTA?

Email your tax ID and your preferred clearinghouse to webhelp@vistahealthplan.com or call us at 866-883-7623.


VISTA utilizes the Availity and Emdeon (formerly WebMD) and HC2000 (Healthcare 2000) clearinghouses. In addition, connectivity directly to VISTA is available for submission of claims and encounters.

Companion Guides
837 Transaction
837R Transaction

Connectivity requirements and technical support information is as follows:

Clearinghouse

Transaction#

Support/Additional Information

Availability

AVAILITY

270 / 271
Eligibility Inquiry

276 / 277
Claims Status Request

278
Authorization/ Referral Inquiry

837
Claims Submission

Email Support:
support@availity.com

Telephone Support:
1-800-AVAILITY
(1-800-282-4548)

For Additional Info:
www.availity.com

24 hours / 7 days per week

Updated within 24 hours of processing

Available for approximately the last 90 days

Emdeon
(formerly WebMD)

837
Claims Submission

Email Support:
hdsupport@webmd.com

Telephone Support:
1-800-845-6592

For Additional Info:
www.webmd.com

24 hours / 7 days per week
HC2000

837
Claims Submission

278
Authorization/ Referral Inquiry

Email Support:
websupport@hc2000inc.com

Telephone Support:
1-800-845-6592

For Additional Info:
www.hc2000inc.com

Monday - Friday
8:30 am - 4:30 pm

VISTA Secure FTP 837
Claims Submission

Email Support:
webhelp@vistahealthplan.com

Telephone Support:
1-866-883-7623

24 hours / 7 days per week

General Information:

  • If you have questions regarding an electronic response, you can contact us at 866-847-8235.  This number can also be found on the back of the member ID card.
  • For specific questions regarding the HIPAA requirements, you can send us an email at hipaa@vistahealthplan.com. If you need immediate assistance, please contact our HIPAA Coordinator at 954-858-3686.
  • Always print system messages or the page on which you need assistance. This will aid us in describing the issue to the technical staff.
  • HIPAA Implementation Guides for all HIPAA transactions are available electronically at   www.wpc-edi.com/HIPAA.

 

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