State agency to move trading-partner EDI functions to new vendor; providers told to check trading partners

Philip Brashear, who identified himself as working with the HPF enterprise project management office, told attendees the department is updating the electronic data interchange (EDI) functions used by trading partners that submit batches of provider claims.

Brashear said the department is "switching to a new system managed by a new vendor called EdFX," and that the migration will require trading partners to use a new platform, new logins, new training and some new procedures. He emphasized this project affects trading partners specifically; "GainWell is still our primary MMIS partner," he said, and GainWell will continue to enroll providers and handle individual claims.

The project is organized in three phases: work started in January, a summer phase will introduce the major trading-partner changes, and the department aims to complete the transition by year-end if the schedule holds. Brashear said the first technical milestone — revised file naming by trading partners — was completed in January and is a prerequisite for the summer changes: "changing how they name files doesn't sound like a lot, but it's a big milestone for the project."

Brashear asked hospitals and provider organizations to check with their trading partners to confirm updates are in place and to refer any EDI questions to the provider web portal or the provider call center. He said the department is accommodating late adopters for now but cannot do so indefinitely.

The department did not announce specific cutover dates beyond the summer target, and said providers will keep their existing provider IDs. The presentation closed with an offer to collect questions and provide follow-up information.

The department supplied a list of resources and encouraged providers to use the provider web portal for further details and contact information.