Setting Up Your Account
To establish your secure Internet account, use your PIN and log on to the secure Web Portal, where you can access the Trade Files menu for submission and retrieval of EDI files.
If you are an enrolled provider and have not received your PIN letter, please call our Web Portal ID/Password Help Desk at 1-800-289-7799, and select option 5 to request a PIN letter.
Ramp Manager
Ramp Manager is an interactive Web site, configured to test X12N transactions against Florida specific processing rules. Florida processing rules are detailed in the Companion Guides. A copy of the Florida Companion Guide for each transaction is available. Click on the Ramp Manager Information Sheet for instructions. Please take a moment to review the information available and schedule time to perform this important testing prior to transitioning to the new version of the transactions.
File Naming Convention
Details on the file naming convention by transaction type for outbound files sent from HP are available in the File Naming Convention document.
EDI File Merge Utility
This application allows you to merge multiple compressed (or zipped) outbound X12 files created by HP into one file. Please review the Merge Documentation for additional information.
Download the Merge Utility software to be able to merge the files.
5010 Informational Summary
Reminder: Florida Medicaid implemented the 5010 version of the HIPAA standard transactions on January 1, 2012.
If your X12 claims transactions are rejected after February 4, 2012, please validate that you are submitting the 5010 version to Florida Medicaid by consulting your clearinghouse or vendor.
HIPAA 5010 versions introduce new formats and additional data elements for transactions and code sets that are required to be implemented by all users of electronic health care transactions. Florida-specific updates will be outlined in the 5010 Companion Guides, when available. Click here for a Quick Reference Guide to the Florida Medicaid Transition to 5010 Transactions.
For Florida Medicaid, the HIPAA transactions listed below will be impacted by the 5010 transition:
5010 Readiness Communications
A letter was mailed to all providers in May 2011 highlighting the information provided on this public portal page. This includes testing options available for submitters, key dates and other information for any provider and vendor submitting or receiving electronic data files from the Florida Medicaid Program and its fiscal agent, HP. Use the links bulleted below to navigate these communications.
Inbound Transactions
Inbound 837 Transactions EDI submitters are required to self validate their 5010 standard claims submissions (837I, 837P and or 837D).
The following Steps for HIPAA 5010 Claim Submission Self Validation are highly recommended for ensuring readiness. 1) Trading Partner tests claims via Ramp Manager. 2) Trading Partner confirms Ramp Manager testing is successful. 3) Trading Partner submits a few production claims in 5010 format. 4) If claims submission successfully process, Trading Partner submits all subsequent transactions in 5010 format and discontinues use of 4010.
The timeline for the 5010 versions of 837 encounter claims is not final. The Steps for HIPAA 5010 Claim Submission Self Validation above for testing HIPAA 5010 claims in production does not apply to 5010 encounter data. Information regarding 5010 encounter specifications will be distributed to health plans when it is available.
Outbound Transactions
HP supports distribution of version 5010 for all outbound EDI transactions. Effective January 1, 2012, all outbound files will be sent in the version 5010 format.
Outbound 834 and 820 HP will use existing communication channels and monthly meetings with managed care health plans to coordinate transition to version 5010. Please anticipate updates through those forums. Managed care plans and MediPass providers must notify HP when they are ready to start receiving 5010 version of the files. To do so, providers should send an email in the following defined format to the Florida EDI Operations Team at: FLEDITeam@hp.com. Specifically:
Samples of the 5010 versions for 820, 834 and 835 transactions are posted below.
SAMPLE 820 FILE
SAMPLE 834 FILE
SAMPLE 835 FILE
5010 SAMPLE 834 DAILY FILE
Testing
Ramp Manager is an interactive website, configured to test X12N transactions against Florida specific processing rules. All Trading Partners are required to test their 5010 X12 inbound transactions via Ramp Manager before sending their production claims to Florida Medicaid. A set of instructions for using the Ramp Manager site and its tools are available. Click on the Ramp Manager Information Sheet for details on its use.
HP staff is available to assist with questions or additional information at 1(866) 586-0961. Please take advantage of the various resources mentioned on this website to prepare for the upcoming change.