EDI Claims Transactions are Now Available on Availity for Texas Independence Health Plan, Inc.
Texas Independence Health Plan, Inc.’s third-party administrator, RAM Technologies has partnered with Availity® to offer you electronic data interchange (EDI) health information exchange services for these transactions, starting Wednesday, March 20, 2024:
- 835 Remittance Advice
- 837 I, P, Claim Submission
- 276/277 Claim Status
Providers and Trading Partners can receive EDI Batch 835 Transactions from Availity for sponsoring Health Plans. Please check the Availity payer list for additional information. You may need to enroll for remits depending on the Health Plan. Certain Change Healthcare and Optum-based health plans may not be available even after enrollment.
We are partnering with Availity.
- Availity has created a microsite to assist health plans, providers, and trading partners. This microsite provides registration help and resources to self-serve on transactions.
- You can access our live EDI webinars after you log in with your Availity EssentialsTM
- For those who cannot self-serve, please send your help requests to an Availity representative.
Which path is right for you?
If you are a new provider to Availity Essentials, you first need to register. You can find instructions, including a recorded demo, in this registration microsite.
If you registered for Availity Essentials and have an FTP account, you can send immediately.
If you need to submit via direct data entry, log in to Availity Essentials, and go to Claims & Encounters and select the type of claim you need to send.
If you are registered for Availity Essentials and do not have an FTP account, you can submit files and pick up reports and ERA files via Availity Essentials. Navigate to Claims & Payments | Send and Receive EDI Files. From this location, you can drop claim files and retrieve claim reports and ERA files. Instructions for this process are in the Upload Transaction Files Through Availity Essentials help topic.
If you are registered for Availity Essentials, do not have an FTP account and would like to submit via FTP, you will need to set up FTP:
- Launch your FTP Client Software
- Create a new entry for accessing the Availity FTP site and use the table below to specify the fields for the new entry.
| Host | ftp.availity.com |
| Port | 9922 (typically used for SFTP) |
| Protocol or server type | Select the appropriate option in your FTP client software for Secure File Transfer Protocol (SFTP). For example, SFTP – SSH File Transfer Protocol |
| Logon type | If there is an option for the logon type, select normal. |
| User | The username for your Availity EDI account. |
| Password | The password for your Availity EDI account. |
Change Healthcare Network Outage
Texas Independence Health Plan, Inc. (TIHP) was alerted on Wednesday, February 21, 2024, about a
cyber security incident that occurred with a downstream vendor, Change Healthcare, impacting some
TIHP operational areas.
Impact to TIHP providers:
- Providers who receive paper checks will experience delays in payments.
- 837 electronic files and paper-to-electronic claims scanning will be delayed.
- 835 Electronic Remittance Advice (ERA) files will be delayed.
- Paper remittance advice will be delayed.
- Electronic (ACH) payments are not affected.
Impact to TIHP members:
- Fulfillment of member materials may be delayed, i.e. welcome kits, ID card requests.
- Important letters to members, for example, authorization decisions and/or appeals and grievance notices may be delayed.
- Premium invoice billing may be delayed.
- Direct Member Reimbursement may be delayed.
TIHP is closely monitoring this situation with our Third-Party Administrator, RAM Technologies, Inc.
Updates to the Change Healthcare network outage issue can be found on the following site: