Availity Medisoft setup
Availity login:
https://apps.availity.com/availity/Login
http://www.availity.com/documents/edi_guide.pdf
| Usage | Value |
| Data Element Separator | “*” Asterisk |
| Subelement Separator | “:” Colon |
| Segment Terminator | “~” Tilde |
| Repetition Separator (5010A1) | “^” Caret |
| Field | Usage | Description | HIPAA Element ID |
| Authorization Information Qualifier |
Code to ID the type of information in the Authorization |
Recommended Value: 00 = No Authorization Information Present |
ISA01 |
| Authorization Information |
Info used for identification or authorization of the sender or the data interchange. |
Recommended Value: (10 blank spaces) |
ISA02 |
| Security Information Qualifier |
Code to ID the type of information in the Security Info. |
Recommended Value: 00 = No Security Information Present |
ISA03 |
| Security Information | Info used for identifying security information about the sender or the data interchange. |
Recommended Value: (10 blank spaces) |
ISA04 |
| Interchange ID Qualifier |
Qualifier to denote the system/method of code structure used to designate the sender. |
Recommended Value: ZZ = Mutually Defined |
ISA05 |
| Interchange Sender ID |
ID code for sender, as defined by Availity. This ID is qualified by the value in ISA05. |
Recommended Value: AV09311993 (+5 blank spaces) |
ISA06 |
| Interchange ID Qualifier |
Qualifier to denote the system/method of code structure used to designate the receiver. |
Recommended Value: 01 = Duns (Dun & Bradstreet) |
ISA07 |
| Interchange Receiver ID |
ID code published by the receiver. This ID is qualified by the value in ISA05. |
Recommended Value: 030240928 (+6 spaces) |
ISA08 |
| Interchange Date | Date of the interchange | Format: YYMMDD | ISA09 |
| Interchange Time | Time of the interchange | Format: HHMM | ISA10 |
| Interchange Control Standards Identifier (4010A1) |
Code to ID the agency responsible for the control standard used by the interchange header and trailer. |
Recommended Value = U |
ISA11 |
| Repetition Separator (5010A1) |
Provides the delimiter used to separate repeated occurrences of a simple data element or a composite data structure. |
Recommended Value = ^ |
ISA11 |
| Interchange Control Version Number |
This version number covers the interchange control segments. |
Recommended Value: 00401 or 00501 |
ISA12 |
| Interchange Control Number |
A unique control number assigned by the sender. |
Recommended Value: Must be identical to the value in IEA02 |
ISA13 |
| Acknowledgement Requested |
Code sent by the sender to request and interchange acknowledgement. (TA1) |
Recommended Value = 1 |
ISA14 |
| Usage Indicator | Code to indicate whether data enclosed is test or production. Test until all Availity validation testing is complete then set to P for Production |
Recommended Values = T or P |
ISA15 |
| Component Element Separator |
The sender identifies the element separator used as a delimiter to separate the data within a composite data structure. Must be different from the data element separator and segment terminator. |
Recommended Value: Any value from the Basic Character Set. |
ISA16 |
| Segment Terminator | Always use tilde as segment terminator. There will be no line feed in X12 code. |
Recommended Value = “~” [Tilde] |
ISA |
| Number of Included Functional Groups |
A count of the number of functional groups included in the interchange. |
Field Length: 1/5 | IEA01 |
| Interchange Control Number |
A control number assigned by the sender. |
Field Length: 9/9 (same as ISA13) |
IEA02 |
| Functional Identifier Code |
Code identifying a group of application related transaction sets. |
HI = Health Care Services Review Information (278) • HR = Health Care Claim Status Request (276) • HN = Health Care Claim Status Notification (277) • HC = Heath Care Claim (837) • HS = Eligibility, Coverage or Benefit Inquiry (270) • HB = Eligibility, Coverage or Benefit Information (271) • HP = Health Care Claim Payment/Advice (835) • FA = 997 Functional Acknowledgement (4010A1) or 999 Implementation Acknowledgement (5010A1) |
GS01 |
| Application Sender’s Code |
Code Identifying party sending transmission. Code agreed to by trading partners. |
Recommended Value (4010A1): AV01101957 • Recommended Value (5010A1): Vendor partners should enter their assigned vendor ID. |
GS02 |
| Application Receiver’s Code |
Code identifying party receiving transmission. Code agreed to by trading partner. |
Recommended Value: 030240928 | GS03 |
| Date | Creation Date | Format: CCYYMMDD | GS04 |
| Time | Creation Time | Format: HHMM (GMT/UTC Standard) | GS05 |
| Group Control Number |
Assigned number originated and maintained by the sender. |
Recommended to be unique over a 6-month period • Must match GE02 |
GS06 |
| Responsible Agency Code |
Code used to identify the issuer of the standard. |
Recommended Value: X = Accredited Standards Committee X12 |
GS07 |
| Version / Release / Industry Identifier Code |
Code indicating the version, release, sub release, and industry identifier of the EDI standard being used. |
835 – 004010X091A1, 005010X221A1 270/271 – 004010X092A1, 005010X279A1 276/277 – 004010X093A1, 005010X212 278 – 004010X094A1, 005010X217A1 837 Institutional – 004010X096A1, 005010X223A2 837 Professional – 004010X098A1, 005010X222A1 |
GS08 |
| Number of Transaction Sets Included |
Total number of transaction sets (ST/SE) included in the functional group or interchange. |
Field Length: 1/6 | GE01 |
| Group Control Number |
Assigned number originated and maintained by the sender. The data interchange control number GE02 in this trailer must be identical to the same data element in the associated functional group header, GS06. |
Field Length: 1/9 | GE02 |
http://chnwmd.com/pdf/Availty%20Reporting%20Preference%20Changes%20for%20ANSI%205010.pdf