Providers and clearinghouses are required to enroll as a Trading Partner to submit claims electronically. Please direct questions to EDI Customer Support at 1.800.952.0495 or by email to firstname.lastname@example.org. View more information about EDI.
Helpful Tips 999 and 997 Responses
- A response file will be produced and posted to your trading partner mailbox for each file you submit to Xerox EDI Direct. It is imperative that you retrieve your response files to determine whether your files were accepted, errored or rejected. If your response file contains any value other than an "A" in the IK5, AK5 or AK9 and you are unsure of the error or rejection, please contact our EDI Commercial Support Team at the number or email below.
- The most common rejections identified are the subscriber ID and the secondary ID (Legacy IDs).
- The subscriber ID in loop 2010BA NM109 should be a 9-byte ID (8 numerics + 1 letter).
- Secondary IDs or Legacy IDs should not be present in the provider loops, with the exception of the tax ID in the 2010AA Billing Loop.
- GCHP Companion Document
- EDI Direct 5010 Communications Document
- WinASAP5010 quick reference guide
- EDI Direct 835 Transaction Form
EDI Commercial Support Team
Government Healthcare Solutions
Gold Coast Health Plan (GCHP) supports electronic funds transfer (EFT). Providers who enroll in EFT will have their Medi-Cal payments directly deposited in their checking or savings account. The EFT option is currently available to in-network providers in Ventura County.
- Certification Page
- Claim Correction Form
- Claims Tips
- FAQs on Claims Issues
- Overpayment Form
- UB-04 Billing Instructions for Long-Term Care
As of December 2020, Gold Coast Health Plan will no longer be accepting the Medi-Cal Long-Term Care (LTC) 25-1 form for claim submissions. Please submit your claims on a UB-04 form.