Sagamore currently sends electronic claims to a variety of clearing houses and
payors. We have found this to be a very fast, accurate and cost-effective
method for handling claims. Sagamore has been working with electronic claims
using standard transactions since the 1990's and has gained valuable expertise
in this field. As more payors are developing the process of receiving
electronic claims they are realizing the benefits of being able to
automatically download and process claims. For more information regarding
testing and setup of electronic claims please contact our EDI Team.
Electronic Claim Format
Sagamore only utilizes HIPAA compliant electronic claim formats. Please click
to view HIPAA implementation guides for electronic claims. We will begin sending and receiving ANSI version 5010 on January 1, 2012.
We will be ready for testing with trading partners January 1, 2011.
To download copies of our 5010 companion documents (PDF's)
please click on the links below.
Sagamore payors have several options to choose from when it comes to receiving
repriced EDI claims. We are connected to several clearinghouses and support
direct connections with many of our payors. Please contact us to discuss which
option would work best for your company. We are open to working with other
clearinghouses as well.
Here is a current list of clearinghouses we can send repriced EDI claims to:
Sagamore's current electronic claims environment supports encrypted internet
When using FTP, all files must be encrypted since they are being transferred over the Internet.
PGP (Pretty Good
Privacy) software to encrypt and decrypt files. Anyone
wanting to do FTP with Sagamore must have the PGP software or something
Please click here to
view Sagamore Data Communication Guidelines (PDF).
PGP Key For EDI Claims
Please click here to
obtain our public PGP key.
For audit purposes, Sagamore has developed a simple confirmation file to verify
all claims have been electronically received by the payor. This file consists
of total claims, total charges, and record counts. Please click
here to review Sagamore's confirmation file layout (PDF).
We can also accept the ANSI 997 acknowledgement.