Medical eBilling

Claim Professional/Institutional/Dental (837)

HIPAA

Health Care Claim Professional - ASC X12N 837 (005010X222A1)
Health Care Claim Institutional - ASC X12N 837 (005010X223A2)
Health Care Claim Dental - ASC X12N 837 (005010X224A2)

Minnesota

Uniform Companion Guide for the Health Care Claim Professional - ASC X12N 837 (005010X222A1)
Uniform Companion Guide for the Health Care Claim Institutional - ASC X12N 837 (005010X223A2)
Uniform Companion Guide for the Health Care Claim Dental - ASC X12 837 (005010X224A2)

These Transactions are performed in a batch mode through our Trading Partners.

Change Healthcare, f.k.a. Emdeon

Contact Change Healthcare at 800-845-6592 for connection information. Or log on at www.emdeon.com
State Farm - (Health) Payer ID is 31053

UHIN

Contact UHIN at 877-693-3071 for connection information.
State Farm's UHIN Trading Partner number is: HT005054-001.

Health Care providers must have either a direct connection, or connection through their clearinghouse, with either Emdeon or UHIN, to send claims to State Farm (Health).

Medicare Crossover

State Farm (Health) accepts electronic bills from the Medicare Coordination of Benefits Contractor (COBC). These transactions are received through an eligibility-based crossover process. State Farm (Health) does not receive claim-based crossover transactions.

These Transactions are available through our Trading Partner.

Mutual of Omaha

Contact Mutual of Omaha at 866-633-9687 for connection information.

Health Care Claim Status Request and Response (276/277)

HIPAA

Health Care Claim Status Request and Response (276/277)
ASC X12N 276/277 (005010X212)

Sending Electronic Health Care Eligibility Benefit Inquiry Transactions

State Farm^® Health Division uses a connection with the clearinghouse, UHIN, to exchange electronic health care eligibility benefit inquiry and response transactions for both HIPAA and Minnesota mandates.

Providers and Electronic Data Exchange (EDI) clearinghouses can contact UHIN for information on how to create the connection. If you are already exchanging electronic health care eligibility benefit inquiry and response transactions with another clearinghouse, they should be able to get your electronic health care eligibility benefit inquiry transactions routed to State Farm^® by way of UHIN.

Contact UHIN at 877-693-3071 for connection information. State Farm's UHIN Trading Partner number is HT005054-001.

Affordable Care Act

CORE Operating Rules, specific to the 276/277 transaction are supported. For additional information, click here.

The Heath Care Claim Status Request and Response transaction will be performed in Real Time mode.

Health Care Claim Payment/Advice (835)

HIPAA

Health Care Claim Payment/Advice (835)
ASC X12N 835 (005010X221A1)

Minnesota

Uniform Standard Companion Guide for Health Care Payment Remittance Advice Electronic Transaction ASC X12N 835 (005010X221A1)

This Transaction is performed in Batch mode, and is available through our Trading Partners.

Affordable Care Act

CORE Operating Rules, specific to the ERA/EFT transactions, are supported. For additional information, regarding each Rule, see the "ERA & EFT Operating Rules page".

ERA Enrollment

It is important you establish a connection with one of the clearinghouses below prior to enrolling with State Farm - Health.

Enrolling requires access to a secure site. Please complete the Contact Us Health Division form to initiate your registration into the secure site.

Change Healthcare, f.k.a. Emdeon

State Farm - Health Payer ID is 31053
Contact Change Healthcare at 866-924-4634 for connection information.

UHIN

State Farm's UHIN Trading Partner number is: HT005054-001.
Contact UHIN at 877-693-3071 for additional connection information.

CAQH - CORE 270 Connectivity Rule (Safe Harbor)

ERA File Retrieval

ERA (835) files are available for retrieval via the Safe Harbor Method of Retrieval for 90 days from the date they are created. Each file retrieval request will result in a single file response if a file is available for the sender of the request for the date requested. If no file is available for the date requested, the response will contain an Error Code of “No File Found” and an Error Message of “No File for date requested available”.

Files are named with the following naming convention. The first component of the file name is your receiver ID, the second component is the date of the file you are requesting, and the third component is STATE FARM’s identifier followed by the type of file it is.

DEG 7, Preference for Aggregation of Remittance Data is where obtain your preference for your receiver ID.

1112223334_20130510_SFCORE.835

The following request would retrieve the above file.

<soapenv:Body>
<ns1:COREEnvelopeBatchResultsRetrievalRequest
xmlns:ns1="http://www.caqh.org/SOAP/WSDL/CORERule2.2.0.xsd">
<PayloadType>X12_005010_Request_Batch_Results_835</PayloadType>
<ProcessingMode>Batch</ProcessingMode>
<PayloadID>f81d4fae-7dec-11d0-a765-00a0c91e6bf6</PayloadID>
<TimeStamp>2013-05-10T10:20:34Z</TimeStamp>
<SenderID>1112223334</SenderID>
<ReceiverID>SFCORE</ReceiverID>
<CORERuleVersion>2.2.0</CORERuleVersion>
</ns1:COREEnvelopeBatchResultsRetrievalRequest>
</soapenv:Body>

Note: Normal processing will result in one file per Business day when remits were processed. However, we are aware that an anomaly to our processing could result in a second file being created for a given Business day. If this occurs you will be contacted and instructions will be provided on how to retrieve this exception file.

Error Handling

If the username and/or password included in the request are not valid an HTTP 403 error response will be returned.

Envelope Processing Status and Error Codes are handled per section 4.3.3.2 of CORE Phase II 270 rule.

ICD10

*Effective October 1,2015, we will accept ICD10 codes for service dates of 10/1/2015 and after.

*We will reject bills with ICD10 codes for service dates prior to 10/1/2015.

*We will reject bills with ICD9 and ICD10 codes, within the same bill.