New York Customers

Testing Guidelines

Helpful Information for Providers/Vendors testing ANSI format:

• It is suggested a minimum of 25, but no more than 50 claims be submitted for each line of business you wish to test.
• The preferred Communication method is via Internet File Transfer.  If you are unable to utilize Internet File Transfer, then FTP or a Network Service vendor is the preferred choice.
• A Telecommunications Manual may be downloaded.  This will guide you through sending files via FTP/PPP, and Internet Communications.
• Important:  The customer is responsible for downloading the response reports for review.  Reports are available for download within 2-4 hours after transmission.  The Response Reports Manual is available to aid you in understanding the reports.  For any questions regarding testing or reports please contact the HelpDesk at 1-800-472-6481, opt. 1.
• The following levels of editing are done on files/claims:

• Level 1 - Syntax Edits - applies to all payers
• Level 2 - Implementation Guide Edits - applies to all payers
• Level 3 - Common Payer Edits - applies to all payers
• Level 4 - Payer Specific Edits - specific for individual payers

Helpful information for Vendors:

• It is important that the software vendor review the Companion Documents before sending test files. (Providers will also benefit from reviewing these documents)
• If you wish to test as a vendor, it will work best if you are able to test with provider numbers that are currently setup with us.
• Implementation guides are maintained by Washington Publishing Company.  To obtain a copy of the ANSI ASC X12N implementation guides, please visit their Web site at wpc-edi.com/hippa.