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
PDF 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:

PDF Companion Guides 5010
Version Published
837I Institutional Claims ​​3.00 ​04/08/14
837P Professional Claims ​​3.00 ​04/08/14
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 ​3.00 ​04/08/14
​278 Health Care Services Review ​2.00 ​07/02/13
820 Payroll Deducted and Other Group Premium Payment for Insurance Products ​2.00 ​07/02/13

 

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