DHHS Internet Website - Medicaid & Long-term Health Care

 Nebraska Medicaid Program

Electronic Data interchange (EDI)

EDI Submission Requirements (5010)

Requirements for exchanging electronic data with Nebraska Medicaid are included in the following document:

EDI Submission Requirements	Version	Published
​ Nebraska Medicaid X12 Submission Requirements Manual using Secure File Transfer Protocol (SFTP)	​2.1	​​08/15/11

Companion Guides (5010) for Nebraska Medicaid requires for ASC X12 Health Care Transactions:

Companion Guides 5010	Version	Published
​837I Institutional Claims	​​2.00	​12/12/12
​837P Professional Claims	​​2.00	​12/12/12
​837D Dental Claims	​​2.00	​12/12/12
​835 Remittance Advice	​2.00	​03/12/13
​834 Benefit Enrollment and Maintenance	​2.00	​03/12/13
​270/271 Health Care Eligibility Benefit Inquiry and Response	​2.00	​01/24/13
​276 Claim Status Request-277 Claim Status Response	​2.00	​03/12/13
​​277 CA Health Care Claim Acknowledgement	​2.00	​01/24/13