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SITEMAP

For Providers > HIPAA Transactions

For Providers - HIPAA Transactions

HIPAA
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) Administrative Simplification (Title II) include provisions for an establishment of standards for electronic health care transactions and national identifiers and code sets as well as privacy of health data.

5010 Transactions
CenCal Health is currently in the process of developing and testing HIPAA 5010 X12 EDI Transactions. Below is the current status of CenCal's supported transactions, and the requirements for each:

Transaction	Title	Current 5010 Status
837	Health Care Claim: Professional & Institutional	Production
	If you are currently submitting 4010 professional claims directly to CenCal Health, please see the CenCal 5010 Companion Guide and Trading Partner Worksheet. Please contact CenCal's HIPAA Workgroup for further testing instructions. If you are currently submitting 4010 claims through Legacy Consulting, please see the CenCal 5010 Companion Guide, and contact your Legacy represenative. If you are a new provider or trading partner who is interested in submitting claims electronically, please contact Jennifer Fraser for further information. .
835	Health Care Claim Payment/Advice	Production
270/271	Health Care Eligibility Inquiry and Reponse	In Development
276/277	Health Care Claim Status Request and Response	Development Pending
834	Benefit Enrollment and Maintenance	Production
	834 Transactions are unique to each trading partner. If you have questions regarding these transactions, please contact CenCal's HIPAA Workgroup.
820	Group Premium Payments for Insurance	Production
	820 Transactions are unique to each trading partner. If you have questions regarding these transactions, please contact CenCal's HIPAA Workgroup. .

Code Sets
CenCal Health supports National Code Sets, mandated by HIPAA, to the limit that Medi-Cal only local codes are made available for use by CenCal Health's programs. As the State of California correlates its Medi-Cal only local codes to national codes, CenCal Health has implemented these changes and instructs billing providers to do the same. Please refer to Medi-Cal website, http://www.medi-cal.ca.gov, for updates.

Privacy
Please go to CenCal'sHIPAA Privacy Practices & Confidentiality statement for information on CenCal Health's implementation of the privacy rules.

File Transport Security
CenCal supports file transfers by FTP, FTPS and SFTP. If sending files using FTP, the files must be secured using PGP. Click here to download CenCal's public key.