Electronic Data Interchange (EDI)
EDI Advantages
When it comes to filing your HIRSP health claims, there is nothing more important than choosing a method that is fast, efficient, and cost effective. This is why HIRSP strongly encourages health care providers to file their claims electronically. Electronic filers receive these benefits:
- Faster claims processing and payment
- Greater data accuracy
- Immediate verification of claims received
- Elimination of paper handling and potential loss of paper documents
- Faster posting of accounts receivable using the HIPAA electronic remittance
transaction
Providers who are interested in filing their claims electronically to the HIRSP administrator, WPS, have four options to choose from:
Option 1: Obtain WPS PC-Ace Pro32 software (free)
Option 2: Choose a vendor who has written software for claims submission to the WPS EDI program
Option 3: Utilize a third-party biller (billing service or clearinghouse)
Option 4: Write your own WPS EDI program
Contact the HIRSP EDI Provider
Once you make the decision to begin sending your claims electronically you need to decide which method you will send. If you are submitting your claims on paper, please contact WPS’ HIRSP EDI department at 1-800-782-2680 to obtain information on how you can begin submitting claims electronically, or visit the EDI section of the WPS Web to obtain enrollment materials.
Paper Claims Submission
If your office is unable to submit electronic claims at this time, you may send your paper claims to the following address: HIRSP
PO Box 8961
Madison, WI 53708-8961.
Medicare Crossover Claims
It is our intent that health claims for HIRSP policyholders with Medicare coverage will be electronically crossed from Medicare to WPS. Please do not submit duplicate claims when the Medicare provider remittance indicates that the claim was crossed over.
