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System Documents

System Documents

Companion Guides

The following documents are companion guides to the National Electronic Data Interchange Transaction Set Implementation Guides, ASC X12N. They are intended for vendors that design software or systems for submitting health care transactions electronically to Arkansas Medicaid. These documents supplement but do not supersede requirements outlined in the ASC X12N implementation guides.

The Health Insurance Portability and Accountability Act (HIPAA) requires Arkansas Medicaid and other covered entities to comply with the electronic data interchange standards for health care as established by the Secretary of Health and Human Services. The ASC X12N implementation guides were established as the standards of compliance. These companion guides provide the supplemental requirements specific to Arkansas Medicaid, as permitted within the transaction sets. The transactions described in these guides are compliant with ACA 1104 standards.

To develop and test a system for Arkansas Medicaid transactions, follow both the applicable implementation guide and its companion guide.

System Transaction/VersionFile NameFile SizeLast Update
270-271 Eligibility
ASCN X12N/005010X279A Version 0.6
276-277 Claim Status
X00510X212 Version 0.2
278 Prior Authorization
X005010217E2 Version 1.0
820 Payroll Deducted and Other Group Premium Payment for Insurance Products
X00510X218 Version 0.2
820 Health Insurance Exchange Related Payments
X005010X306 Version 0.1
834 Benefit Enrollment and Maintenance
X00510X220A1 Version 1.5
835 Payment/Advice
X005010221A1 Version 2.0
837 Dental
X005010X224A2 Version 0.7
837 Professional
X005010X222A1 Version 0.9
837 Institutional
X005010X223A2 Version 2.0
NCPDP Payer Sheet
Magellan Medicaid Administration NCPDP D.0 Payer Sheet

EDI-X12 Submitter Resources



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CORE Services

Trading Partner EDI File Submission Methods/Instructions offers vendors greater detail and guidance.

Trading Partner – Testing Guidelines

The following document is essential for vendors who are preparing to test HIPAA-compliant transactions.

DocumentFile NameFile Size
Trading Partner – Testing GuidelinesTradingPartnerTest.doc137k

Other Vendor Resources

The following documents contain additional information that may be useful to vendors:

DocumentFile NameFile Size
Trading Partner EDI File Submission Methods/Instructionsbbs.doc530k
HIPAA X12 Transactions Supported by Arkansas Medicaidx12tran.doc53k
Miscellaneous Error Codesmiscerror.doc40k
Start/Stop Reason CodesStartStopReasonCodes.xlsx14k
Third Party Liability Major Coverage Codestplcodes.doc116k
Third-Party Liability Unit Contact InformationDMSTPL.doc31k