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May 1, 2012 - April 30, 2013
Companion guides are developed to communicate Medical Assistance-specific information required to successfully submit healthcare transactions. They usually contain the department’s interpretation and application of the data elements and how to convey the data for department transactions.
Below are links that will guide you to the companion guides available for use with PROMISe.
ANSI X12 v5010 and NCPDP vD.0
Companion guides associated with ANSI v5010 healthcare transactions and NCPDP D.0 pharmacy transactions. These versions are valid beginning Jan. 1, 2012. These guides are available for programming and certification activities with the PROMISe™.
- U277 - Unsolicited 277 Claim Status * (06/11)
- 270/271 - Eligibility Benefit Inquiry and Response * (01/13)
- 276/277 - Claim Status Request and Response * (01/13)
- 820 - Premium Payment for Insurance Products * (01/13)
- 834 - Benefit Enrollment and Maintenance * (01/13)
- 835 - Remittance Advice * (01/13)
- 837 - Dental * (01/13)
- 837 - Institutional - Inpatient * (01/13)
- 837 - Institutional - Long Term Care * (01/13)
- 837 - Institutional - Outpatient * (01/13)
- 837 - Professional * (01/13)
- 837 - Professional - Drug * (01/13)
- NCPDP Version D.0 * (10/11)
- NCPDP Batch 1.2 * (09/10)
- NCPDP D.0 Desk Reference * (12/11)
* These documents are in Adobe Acrobat pdf format. You must have a copy of Adobe Acrobat Reader.
