File #: A 14-048    Name: Gateway EDI
Type: BoS Agreement Status: Passed
File created: 4/18/2014 In control: Board of Supervisors
On agenda: 5/6/2014 Final action: 5/6/2014
Title: a. Approve and authorize execution by the Director of Health of Electronic Data Interchange ("EDI") Provider Trading Partner Agreement, authorizing Gateway EDI to receive County of Monterey d/b/a/ Monterey County Health Department Laboratory ("County Laboratory") claim files of TRICARE beneficiaries for submission to PBGA, L.L.C.; and b. Approve and authorize execution by the Director of Health of Addendum to ERA Enrollment Form for Billing Services and Clearinghouses between County of Monterey d/b/a Monterey County Health Department Laboratory and PGBA, LLC, authorizing Gateway EDI to receive Electronic Remittance Advices ("ERAs") in connection with County Laboratory claim files of TRICARE beneficiaries for submission to PBGA, L.L.C; and c. Approve and authorize execution by the Director of Health of Medi-Cal Telecommunications Provider and Biller Application/Agreement, authorizing Gateway EDI to receive County Laboratory claim files of Medi-Cal beneficiaries for submission to the C...
Sponsors: Ray Bullick
Attachments: 1. PBGAL L C .pdf, 2. Addendum PBGA L L C .pdf, 3. California Department of Health Care Services.pdf, 4. California Department of Health Care Services - 835 -Transaction Data.pdf, 5. Anthem Blue Cross.pdf, 6. Blue Shield of California.pdf, 7. Completed Board Order
Title
a. Approve and authorize execution by the Director of Health of Electronic Data Interchange ("EDI") Provider Trading Partner Agreement, authorizing Gateway EDI to receive County of Monterey d/b/a/ Monterey County Health Department Laboratory ("County Laboratory") claim files of TRICARE beneficiaries for submission to PBGA, L.L.C.; and
b. Approve and authorize execution by the Director of Health of Addendum to ERA Enrollment Form for Billing Services and Clearinghouses between County of Monterey d/b/a Monterey County Health Department Laboratory and PGBA, LLC, authorizing Gateway EDI to receive Electronic Remittance Advices ("ERAs") in connection with County Laboratory claim files of TRICARE beneficiaries for submission to PBGA, L.L.C; and
c. Approve and authorize execution by the Director of Health of Medi-Cal Telecommunications Provider and Biller Application/Agreement, authorizing Gateway EDI to receive County Laboratory claim files of Medi-Cal beneficiaries for submission to the California Department of Health Care Services; and
d. Approve and authorize execution by the Director of Health of Medi-Cal Telecommunications Provider and Biller Application/Agreement, authorizing Gateway EDI to receive 835-Transaction Data in connection with County Laboratory claim files of Medi-Cal beneficiaries submitted to the California Department of Health Care Services; and
e. Approve and authorize execution by the Director of Health ERA Enrollment Form, authorizing Gateway EDI to receive ERAs in connection with County Laboratory claim files of Anthem Blue Cross beneficiaries; and
f. Approve and authorize execution by the Director of Health of Provider Authorization Form Electronic Payment Information, authorizing Gateway EDI to receive ERAs in connection with County Laboratory claim files of Blue Shield of California beneficiaries; and
g. Approve and authorize execution by the Director of Health, subject to County Counsel approval, of additional written authorizati...

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