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Electronic Data Interchange (EDI) Support

The 5010X12 835 Companion Guide has been updated. This update includes changes to the PER segment and the REF segments.

Communications to Submitters

 

New Enrollment

In order to submit or receive batch files (such as claims or eligibility) in the Colorado interChange system, submitters must enroll as a Trading Partner for the Colorado interChange and pass test transactions for HIPAA compliance.

Only one Trading Partner application needs to be completed per Trading Partner, even if the Trading Partner submits for multiple providers. Accurate and timely completion of the profile form will prevent delays in testing and approval for production processing.

A Trading Partner ID (TPID) is ONLY needed to receive EDI information from or transmit EDI information to the Colorado interChange, and ONLY the submitter or receiver needs the TPID. Submitters of interactive (single) claims through the Provider Web Portal do not need a TPID anymore (unless to receive an 835). If a TPID is not needed, it is not necessary to enroll as a Trading Partner.

Example 1: Clearinghouse XYZ submits batch claims for Dr. Jones. In this example, Clearinghouse XYZ needs a TPID, Dr. Jones does not.
Example 2: Dr. Pepper submits his own batch claims using software from a vendor. In this example, Dr. Pepper needs a TPID.
Example 3: Dr. Doolittle submits her own interactive (single) claims through the provider Web Portal. In this example, Dr. Doolittle does not need a TPID.
Example 4: In addition to submitting single claims through the Web Portal, Dr. Doolittle also has Clearinghouse XYZ submit batch claims for her. Clearinghouse XYZ needs a TPID (they can use the same TPID from example 1). Dr. Doolittle still does not need a TPID.

Step 1:
Download and review the Getting Started Guide for enrollment instructions.

Step 2:
Complete Trading Partner enrollment.

Step 3:
Download the Testing Packet, complete the testing process and receive approval to submit production transactions.

Step 4:
Register for the Provider Web Portal as a "Billing Agent" and assign a Trading Partner Administrator.

Step 5:
After receiving approval for production transactions, send the TPID to the providers who will be submitted for. Refer to the Updating an ERA X12 835 Information -Provider Web Portal Quick Guide, available on the Quick Guides and Webinars web page. Submitters can refer providers to this resource.

Step 6:
Providers add you as a Registered Billing Agent/Clearinghouse/Switch Vendor (see instructions in step 5).

Step 7:
Submit production batch claims.

Update to Billing Provider ID Requirements on Batch Submissions

Previously, if a submitter used identical information in Loop 2310C N3 and N4 and Loop 2010AA N3 and N4 for the billing provider information, the file would not receive a compliance error. As of May 18, 2018, this has been corrected to comply with the X12 standards and users will receive an error if the two fields have identical information. Contact EDI services at 1-844-235-2387, option 3 for more information.

Need Assistance?

The EDI Help Desk is available through the Provider Services Call Center (1-844-235-2387).

Companion Guides and Instructions