EDI Companion Guides

The companion guides clarify, supplement and further define specific data content requirements to be used in conjunction with, and not in place of, the X12 Technical Review Type 3 (TR3s) Implementation Guides for all transactions mandated by HIPAA and/or adopted by Magellan Health for Electronic Data Interchange (EDI). EDI addresses how Providers, or their business associates, exchange Professional and Institutional Claims, Claim Acknowledgments, Claim Remittance Advice, Claim Status Inquiry and Response, and Eligibility Inquiry and Response transactions with Magellan Health. These guides also apply to the above referenced transactions that are being exchanged with Magellan Health by third parties, such as clearinghouses, billing services or network service vendors.

These companion guides also provide communication, connectivity, and transaction specific information to Magellan Health trading partners and serves as the authoritative source for Magellan Health specific EDI protocols.