edi education

EDI Academy Facebook Official Page is ready to give your the latest EDI news EDI Academy Facebook Page invites you to give us your “Like” and stay tuned for the latest news: upcoming EDI events including seminars and trainings EDI Academy trainings releases electronic data interchange in retail, logistics, supply chain, healthcare EDI standardization worldwide best EDI implementation Read More →

835 EDI

835 EDI transaction usage description The 835 EDI is an important aspect for the provider of service. Most providers of service have an internal mechanism to parse the 835 EDI into their accounting programs. The receipt of the 835 EDI is a major labor savings device for financial reconciliation of the claim to determine any Read More →

Affinity Health Plan 837 Claims

835 Transaction  balancing description and formula The 835 Transaction is used primarily by Healthcare insurance plans to make payments to healthcare providers, to provide Explanations of Benefits (EOBs), or both. It has been specified by HIPAA 5010 requirements for the electronic transmission of healthcare payment and benefit information. Dollar amounts on the 835 Transaction must balance. The Read More →

835 Health Care Claim Payment/Advice

835 Health Care Claim Payment/Advice definition and related transactions Once the claim is ready to be paid an 835 Health Care Claim Payment/Advice can be used in the following ways: Make the payment; Provide an Explanation of Benefits (EOB); Make a payment and send an Explanation of Benefits. 835 Health Care Claim Payment/Advice Purpose & Scope A very Read More →

EDI claims

276, 277 EDI transactions details 276, 277 EDI transactions examples are presented below for better understanding of the transaction sets. 276, 277 EDI transactions purposes: the 276 transaction is designed to be exchanged for a 277 response containing the benefit information sought in the 276 request. Should the 276 fail structural validation upon receipt, a 999 Read More →

Audi_PaperLiberation_6

Healthcare 276 and 277 Claim Status Request (276) and Claim Status Notification (277) definition Healthcare 276 and 277 EDI transactions described in today’s post refer to HIPAA EDI definitions. The 276 Claim Status Request can be used by a provider to request status of a claim. Key elements used on the request are provider number, patient identifier, Read More →

UnitedHealthcare EDI Transaction

UnitedHealthcare EDI transactions – notifications UnitedHealthcare EDI transactions described in the post are as following: Electronic Admission Notifications (278N), Electronic Authorization and Notification Inquiries (278I), Electronic Pre-Authorization and Advance Notifications (278A) Electronic Admission Notifications (278N) The UnitedHealthcare EDI 278N transaction is a way to exchange admission notification data between an inpatient facility and UnitedHealthcare in a standard format. Read More →

healthcare claims

HealthSmart Claims EDI Clearinghouse services HealthSmart Claims solution for payors and those with self-administered health plans, offers complete Electronic Data Interchange (EDI) Clearinghouse services. HealthSmart Claims Information Systems offers significant operating efficiencies to the healthcare industry through a range of solutions that streamline electronic claims processing. HealthSmart Claims services facilitate “clean claims,” resulting in reduced Read More →

edi clearinghouse

HealthSmart EDI provider and vendor solutions HealthSmart EDI program offers a Full Service Healthcare EDI Clearinghouse. It is open to all providers in the healthcare community. The goal at HealthSmart is to give network providers the highest level of customer service possible. HealthSmart is engineered with the latest technology and is committed to meeting all HIPAA requirements Read More →

EDI 5010

EDI 5010 Version Changes EDI 5010 recent updates can influence correspondence in healthcare claims exchange and flow between partners. It is recommended that both parties take part in EDI 5010 updates testing procedures in order to prevent delays or issues in processing your claims cycle. EDI 4010 to EDI 5010 basis The centers for Medicare and Read More →