Nebraska Medicaid Program

Electronic Data Interchange (EDI)

EDI Testing

SFTP Testing Process 

  1. EDI Help Desk staff will confirm your Trading Partner EDI Enrollment is complete and will establish your test status. The Medicaid Providers provided to us on the Trading Partner Authorization(s), must be loaded into our test region (an overnight process) before testing can begin.
  2. After test status has been established, the EDI helpdesk will email log-in information to the contacts provided on the Trading Partner Profile.  The email will also confirm we are ready to receive your test files in the “In Box” on the testing server.
  3. Response files and test results are placed in your "Out Box" on the testing server.  At least two successful test files with 20-25 claims/inquiries are required before approval for production.

SFTP TEST FILE REQUIREMENTS:

  • Each transaction you selected on the Trading Partner Profile must pass the testing process before moving to production.  Exception includes outbound only files (835*, 277CA).
  • Each test file must have 20 to 25 claims/inquiries per test file.  Two successful files for each transaction are required before moving to production.
  • The Trading Partner Authorization provided to NE Medicaid during enrollment will establish the providers for use in your test files.  Work with these providers to acquire active data to use on the claims/inquires.
  • We follow the TR3 guide (available for purchase) industry standard for our file format.  Any NE Medicaid specifics can be found in our companion guides.
  • The EDI Help Desk will contact the Trading Partner after two successful test files are received to determine the date for moving the transaction(s) into production status.

*The 835 transaction does not require testing and will be delivered to the Trading Partner effective the cycle following the enrollment.  835 files are delivered on Monday evenings (Tuesday when Monday is a holiday), also delivered at that time are provider Refund Request Reports.

HTTP/S Testing Process

  1. EDI Help Desk staff will confirm your Trading Partner EDI Enrollment is complete and will establish your test status.
  2.  After test status has been established, the EDI helpdesk will email user ID information to the contacts provided on the Trading Partner Profile.  The email will also confirm we are ready to receive your test files.

HTTP/S TEST FILE REQUIREMENTS:

  • Each transaction and each method (real-time or batch) for the transaction you selected on the Trading Partner Profile must pass the testing process before the Trading Partner is able to submit production transactions.
  • The Trading Partner Authorization provided to NE Medicaid during enrollment will establish the providers for use in your test files.  Work with these providers to acquire active data to use on the test inquires.
  • We follow the TR3 guide (available for purchase) industry standard for our file format.  Any NE Medicaid specifics can be found in our companion guides.

Real-Time

  • The Trading Partner must complete 5 successful test inquiries.
  • After successfully completing all required test transactions, the Trading Partner will complete a HTTP/S Trading Partner Testing Status Form
  • The Trading Partner will submit the HTTP/S Trading Partner Testing Status Form to the EDI Help Desk via e-mail.
  • Nebraska Medicaid will review the inquiries and provide feedback to the Trading Partner.
  • After testing is successfully completed, the EDI Help Desk will coordinate with the Trading Partner to determine a production date.

Batch

  • Trading Partners must submit a minimum of two test files, without exceeding 99 inquiries per transaction set, where the majority of inquiries process correctly.
  • After successfully completing all required test transactions, the Trading Partner will complete a HTTP/S Trading Partner Testing Status Form.
  • The Trading Partner will submit the HTTP/S Trading Partner Testing Status Form to the EDI Help Desk via e-mail.
  • At testing is successfully completed, the EDI Help Desk will coordinate with the Trading Partner to determine a production date.

Medicaid EDI Help Desk

866-498-4357 (toll free) or 471-9461 (in Lincoln)

 

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