Batch billing refers to the electronic creation and transmission of several claims in a group. Batch billing
systems usually extract information from an automated accounting or patient billing system to create a
group of claim transactions. Claims may be transmitted from the provider's office or sent through a
billing vendor or clearinghouse.
All batch claim submission software must be tested and approved by the Department’s fiscal agent.
Any entity sending electronic transactions through the fiscal agent’s Electronic Data Interchange (EDI)
Gateway for processing where reports and responses will be delivered must complete an EDI enrollment
package. This provides EDI Gateway the information necessary to assign a Logon Name, Logon ID, and
Trading Partner ID, which are required to submit electronic transactions, including claims.
The X12N 837 Professional (837P), Institutional (837I), or Dental (837D) transaction data will be
submitted to the EDI Gateway, which validates submission of American National Standards Institute
(ANSI) X12N format(s). The TA1 Interchange Acknowledgement reports the syntactical analysis of the
interchange header and trailer. If the data is corrupt or the trading partner relationship does not exist
within the Medicaid Management Information System (MMIS), the interchange will reject and a TA1
along with the data will be forwarded to the State Healthcare Clearinghouse (SHCH) Technical Support
for review and follow-up with the sender. An X12N 999 Functional Acknowledgement is generated when
a file that has passed the header and trailer check passes through the SHCH.
If the file contains syntactical error(s), the segment(s) and element(s) where the error(s) occurred will
be reported. After validation, the SHCH will then return the X12N 835 Remittance Advice containing
information related to payees, payers, dollar amount, and payments. These X12N transactions will be
returned to the Web Portal for retrieval by the trading partner, following the standard claims processing
cycle.
