Electronic Data Interchange (EDI) Provider Resources

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Medicare EDI

  • MAC J5—Part A and B
  • MAC J8—Part A and B
  • J5 National—Part A only

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  • TRICARE For Life
  • TRICARE Overseas
  • TRICARE East

A team of consultants on your side

The WPS Corporate Services–EDI department has a dedicated team whose primary function is to consult and serve providers regarding Electronic Data Interchange (EDI) use. Our team is experienced in dealing with a variety of provider specialties, billing services, and software vendors.

We continue to offer and improve our superior EDI software products based on our Trading Partners’ needs, as well as our supplemental EDI products, such as Electronic Remittance Advice (ERA), Electronic Funds Transfer (EFT), and real-time eligibility and claim status transactions

WPS Health Insurance has years of experience in EDI transaction processing. We provide EDI services to our Trading Partners for WPS Health Insurance, TRICARE East Region, TRICARE Overseas, TRICARE For Life, Medicare MAC J5 Parts A and B, MAC J8 Parts A and B, and WPS Health Plan contracts.

We look forward to working closely with all of our Trading Partners to provide excellent EDI service and support today and into the future. Providers who are interested in becoming an EDI Trading Partner with WPS should contact our EDI team.

For the WPS Health Insurance, WPS Health Plan, Family Care/Children’s Program and UCARE lines of business, the 277CA Claims Acknowledgments are processed by a third party, Smart Data Solutions (SDS). Acknowledgment files (TA1, 999, 277CA) will be available in the same location within WPS Gateway Express. Due to the validation and edit process, multiple 277CAs may be generated for claims within a single file/transaction. For electronic claim file rejections and acknowledgment questions, please contact SDS at stream.support@sdata.us or 855-297-4436.

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