Electronic Data Interchange (EDI) FAQs

  1. Which clearinghouse does HMAA use?
  2. How do I contact Smart Data Solutions?
  3. Does HMAA accept claims directly via website?
  4. What if I am already sending claims through Smart Data Solutions for other payors?
  5. What if I am already sending claims to another clearinghouse?
  6. What types of electronic claim formats do HMAA accept?
  7. How can I be sure that HMAA is receiving our claims?
  8. Why is HMAA not receiving our claims transmission?
  9. Why is HMAA receiving paper claims from us when we transmit electronically?
  10. Should I submit the same claims electronically AND by paper just to be sure they are received?
  11. Does HMAA provide Electronic Remittance Advice (ERA) and Electronic Payment Services?

  1. Which clearinghouse does HMAA use?

    Effective November 1, 2014, HMAA is using Smart Data Solutions (SDS) as its EDI clearinghouse under payor ID 48330.

  2. How do I contact Smart Data Solutions?

    You can call Smart Data Solutions Monday through Friday from 9 am – 5 pm CST toll-free at (855) 297-4436 or email stream.support@sdata.us to set up a direct connection.

  3. Does HMAA accept claims directly via website?

    In some cases, HMAA may accept direct submission of electronic claims. Please contact us to discuss transmittal options.

  4. What if I am already sending claims through Smart Data Solutions for other payors?

    If you already are sending claims through Smart Data Solutions for other payors, you do not need to contact SDS.  Just begin submitting HMAA claims electronically following SDS’ guidelines.

    If you are not currently submitting claims through SDS for other payors, you or your billing vendor will need to establish a connection for electronic submission with SDS.  You can call Smart Data Solutions Monday through Friday from 9 am – 5 pm CST toll-free at (855) 297-4436 or speak with their EDI contact, Dipesh Patel, at (651) 289-7940 or email dpatel@sdata.us to set up a direct connection.

  5. What if I am already sending claims to another clearinghouse?

    If you currently use a clearinghouse for electronic submission of claims to other payors, you may be able to submit HMAA claims through your existing relationship.  SDS accepts claims from Claimsnet, Proxymed, Medavant, THIN, ENS, and several others.  Please contact Smart Data Solutions Monday through Friday from 9 am – 5 pm CST toll-free at (855) 297-4436 or speak with their EDI contact, Dipesh Patel, at (651) 289-7940 or email dpatel@sdata.us to determine whether your current clearinghouse may be utilized for submission of electronic HMAA claims.

  6. What types of electronic claim formats do HMAA accept?

    HMAA will accept 5010 standard EDI claims through the SDS clearinghouse.

  7. How can I be sure that HMAA is receiving our claims?

    You should review the confirmation and rejection reports supplied by your vendor and SDS  each time you transmit claims to HMAA.  These reports should be used to compare your actual submission totals against the totals shown on the reports.  They will confirm which claims have reached their destination and which claims were rejected.  If you do not currently receive these reports or you are unsure about how to use them, please contact your vendor.

    Regardless of your EDI vendor, when you send a claim electronically to HMAA, it will be processed through SDS.  At SDS, the claim goes through a set of standard edits to make sure the claim is error-free.  If the claim meets these standard requirements, SDS accepts the claim and forwards it to HMAA.  If the claim is missing required information or does not meet SDS’ edits, SDS rejects the claim and the claim does not reach HMAA.

  8. Why is HMAA not receiving our claims transmission?

    This problem could result from many different causes.  Please review the steps below to determine the most viable solution:

    1. Verify that all claims are transmitted to HMAA from both your vendor and SDS by routinely reviewing your confirmation and rejection reports.
    2. Make certain all eligible claims in your system are flagged to go out electronically to SDS using HMAA’s payor ID, 48330.
    3. Check with your vendor to verify they are receiving all of your claims.
    4. Ask your vendor to contact SDS to verify that all of your claims are received.
    5. Some vendors require an additional number for electronic routing unique to their vendor requirements, or a reference regarding the actual payor address/name information passed to determine electronic routing. Please check with your vendor to determine vendor-specific edits for routing claims electronically to HMAA.
    6. If all of the above has been checked and verified, but HMAA is still not receiving your claims, please contact our Provider Relations Department for assistance at (808) 591-0088 or toll-free at (800) 621-6998, or by e-mail at ProviderRelations@hwmg.org.
  9. Why is HMAA receiving paper claims from us when we transmit electronically?

    Some vendors offer a service that automatically converts electronic claims to paper if they are rejected during transmission to the next vendor.  Review your SDS rejection reports and contact your vendor to discuss how they handle rejected claims.

  10. Should I submit the same claims electronically AND by paper just to be sure they are received?

    Please choose either paper or electronic filing, not both. Filing twice, by paper and electronically, will result in duplicate claim handling by HMAA. Note: This does not apply to specific requests by HMAA for paper claims with additional attachments that must be submitted by paper.

  11. Does HMAA provide Electronic Remittance Advice (ERA) and Electronic Payment Services?

    Yes, we offer ERA and ePayment services through Pay-Plus Solutions, Inc. (PPS). Contact our Provider Relations Department at ProviderRelations@hwmg.org for further information.