1

Anesthesia Standard

This standard provides rules for billing anesthesia claims in the State of Utah

2-A

UB-92 Form Locator Elements - Also see Specification 41A for flat file/print imageUB-92 Crosswalk

This Standard provides a free crosswalk between the UB-92 claim form and the institutional health care claim transaction (837).   This crosswalk is for the use of the HIPAA institutional claim transaction within the State of Utah.

2-B

HCFA-1500 Box Elements - Also see Specification 41B for flat file/print image

This Standard provides a crosswalk between the HCFA-1500 claim form and the professional health care claim transaction (837).  This crosswalk is for the use of the HIPAA professional claim transaction within the State of Utah.

2-D

Dental Form Locator Elements - See Specification 41D for flat file/print image

This Standard provides a crosswalk between the ADA 2000, 1994, 1990 claim forms and the dental health care claim transaction (837).  This crosswalk is for use of the HIPAA dental claim transaction within the State of Utah.

3

837 Health Care Claim Standard

This Standard details the use of the HIPAA 837 implementation guides for UHIN members.

4

Provider Remittance Advice Standard

This Standard establishes the uniform standard  for the electric remittance advice transaction used in the State of Utah.

4

Provider Remittance Advice - Flat File Specification

This specification details the flat file output from UHINT application for the benefit of  provider systems.  

5

Trading Partner Number/UHIN Routing Number

This specification establishes a standard trading partner number and UHIN routing number practices for the UHIN network.

6

Health Identification Card

This standard standardizes the patient identification card information. This card addresses the human-readable appearance and machine readable information used by the healthcare industry to obtain eligibility and/or benefit information

8

Patient Identification Number

This standard establishes the SSN as the Utah standard for the patient's identification number.  

9

Professional Common Edits

This standard establishes the common (UHIN) edits for professional claims submitted in the State of Utah.

9

Professional Common Edits Spreadsheet

This documents contains the professional common edits in a spread sheet format. This document is to be used in conjunction with the Professional Common Edits Standard.

10

Facilities Common Edits

This standard establishes the common (UHIN) edits for facility (institutional) claims submitted in the State of Utah.

10

Facilities Common Edits Spreadsheet

Thisdocument contains the facilities common edits in a spreadsheet format. This document is to be used in conjunction with the Facitities Common Edits Standard.

11

834 - Medicaid Enrollment Standard

This standard establishes the use of the ASC X12 834 Enrollment transaction for Utah State Medicaid enrollments.

12

HCFA 1500 Box 17 and 17A

This standard establishes a standard approach to reporting referring provider name and identifier number on the HCFA 1500 claim form.

18

Functional Acknowledgement

This standard establishes the use of the ASC X12 997 transaction for use as a functional acknowledgement for HIPAA transactions in the State of Utah.

20

Front End Acknowledgement Standard 

This standard establishes the use of the ASC X12 277 unsolicited transaction to use as a front-end acknowledgement for claim submission within the State of Utah. This standard also includes the UHIN Implementation Guide for the required transaction.

20

Front End Acknowledgement Cross Walk

This is a supporting document that provides a uniform method for the use of the STC codes within the 277FE.  This document is meant to be used in conjunction with Standard #20 Front End Acknowledgment and Specification #20 Front End Acknowledgement . 

22

Minimum Hardware Requirements

This specification establishes the minimum hardware requirements for connecting to the UHIN switch and using  UHIN base line translators to connect to UHINet.

23

Sender and Receiver Identification In the
ISA and GS Segments

This specification establishes a standard use for various elements in the ISA and GS segments.

24

Payer, Provider and Vendor Network Requirements

This standard defines the network connect requirements for payers, providers and vendors.

26

Telehealth

This standard establishes standard billing practices for Telehealth claims in the State of Utah.

27

Coverage for Metabolic Dietary Products

This standard establishes standard billing practices for metabolic dietary products in the State of Utah.

28

Home Health

This standard establishes standard billing practices for Home Health and Home Infusion claims in the State of Utah.

30

Pain Management

This standard establishes a uniform method of submitting pain management claims/encounters, pre-authorizations and notifications.

31

Eligibility Inquiry and Response Standard

This standard establishes a uniform method of eligibility inquiry and responses practices within the State of Utah .  

Eligibility Inquiry Examples

This is a supporting document that provides a uniform method for the use of the eligibility transaction (270/271) for various levels of inquiry.  This document is meant to be used in conjunction with Standard #31Eligibility Inquiry and Response Standard.

Eligibility Response Examples

This is a supporting document that provides a uniform method for the use of the eligibility transaction (270/271) for various levels of response .  This document is meant to be used in conjunction with Standard #31Eligibility Inquiry and Response Standard.

32

Benefits Enrollment and Maintenance Standard

This standard establishes the enrollment and maintenance process practices for the State of Utah . 

34

Psychiatric Day Treatment Standard

This standard establishes a uniform method of transacting psychiatric day treatment billing, prior authorization and referral practices.

35

Prior Authorization/Referral Standard

This standard establishes the uniform method for the Prior Authorization/Referral transaction (278) in the State of Utah.  This standard applies to both payers and providers

36

Claim Status Inquiry

This standard establishes the uniform method for the Claim Status transaction (276/277) in the State of Utah.  This standard applies to both payers and providers and sets minimum requirements for each.

37

Individual Name

This standard establishes guidance for entering names into any Utah provider, payer or sponsor systems for patients, enrollees, as well as all other people associated with these records

38

Security

This specification establishes standard security practices for UHINT and UHINet users.

39

Testing and Certification

This specification establishes standard testing and certification practices for transition to the HIPAA compliant transactions.

41A

Institutional Flat File (Part I)

In this specification Part I establishes a free flat file specification to be used by UHINT for institutional claim submission.

Institutional Print Image (Part II)

In this specification Part II establishes a specification for a free print image specification used by UHINT for institutional claim submission.

41B

Professional Flat File (Part I)

In this specification Part I establishes a free flat file specification used by UHINT for professional claim submission. 

Professional Print Image (Part II)

Part II establishes a free print image specification used by UHINT for professional claim submission's

41D

Dental Flat File (Part I)  

In this specification Part I details the flat file technical specifications used by UHINT for dental claim submission.  

Part II establishes a free print image specification that can be used by UHINT for dental claim submission.

43

Eligibility Inquiry Flat File Specification

This specification details the UHINT flat file for eligibility transactions for those wishing to use in a batch mode for eligibility transactions.

44

Claim Status Flat File Specification

This specification provides the a flat file technical specifications for those whishing to use UHINT in a batch mode claim status transactions.

47

Change Mangement

This UHIN Specification is intended to provide a process for UHIN members to follow when changes to UHIN services are requested or implemented.

49

Provider Data Exchange

This specification supplies the specification for those entities that intend to use UHINspeedi for exchanging enrollment/crednetialing data through UHINet.

50

Coordiantion of Benefits

This UHIN Standard is intended to streamline the coordination of benefits process between payers and providers. The over all goal of this standard is to define the miminm data to be exchanged for the coordination of benefts.

51

National Provider Identifier

This UHIN Standard is intended to assist with the transition from legacy provider numbers to the NPI for pauer and providers

v1.0
07/10/06

n/a

Route Server Connection Document

This document explains how to connect to UHINet as a Route Server

v1.1
05/02/08

n/a

Router Client Connection Document

This document explains how to connect to UHINet as a Provider.

v1.2
05/02/08