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Companion Guides

Kentucky Medicaid Companion Guides

Companion Guide instructions are displayed in Adobe Acrobat formats.

The transaction under HIPAA is the standard electronic exchange of information between two parties to carry out financial activities related to health care. The health care claim or equivalent encounter information transaction is the transmission of either of the following:

  • A request to obtain payment, and the necessary accompanying information from a health care provider to a health plan, for health care.
  • If there is no direct claim, because the reimbursement contract is based on a mechanism other than charges or reimbursement rates for specific services, the transaction is the transmission of encounter information for the purpose of reporting health care.
Companion guides document situational fields from the Implementation Guide, that are required to process Kentucky Medicaid claims. However, the documents are not the complete EDI transaction format.

Companion Guides

837D Dental Companion Guide - X12 approved

837I Institutional Companion Guide - X12 approved

837P Professional Companion Guide - X12 approved

277U Health Care Payer Unsolicited Claim Companion Guide - X12 approved

835 Companion Guide - X12 approved

EDI Guides

Ramp Manager User Manual

Kentucky Health Net user manuals

Other sites

KY Medicaid:https://chfs.ky.gov/agencies/dms/Pages/default.aspx

WPC:www.wedi.org

CMS::www.cms.gov

Managed Care Organization contacts

For a complete list of MCO contacts https://chfs.ky.gov/agencies/dms/dpqo/Pages/mco-contracts.aspx

EOB Crosswalk (PDF)

Last Updated 5/15/2019 
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