837 Claim Rejections: The Edge Cases Your Clearinghouse Won’t Catch Most clearinghouse edits catch the obvious stuff — missing NPI, malformed dates, invalid ISA/GS envelopes. That’s table stakes. The rejections that actually cost you time and revenue are the ones that pass clearinghouse validation cleanly and still bounce at the payer, because the clearinghouse is … Read More →
Healthcare EDI Market Set to Grow 60% by 2031 — What’s Driving It (Research And Markets) A new market research report puts a number on something healthcare EDI practitioners have felt for years: this isn’t a mature, flat industry — it’s still growing, and growing quickly. According to a report published August 4, 2026 by … Read More →
Steps for Enrolling Providers and Authorizing Clearinghouses/Billers in Medicare EDI In Medicare EDI, enrollment is not just a technical setup step. It is a formal authorization process that determines who may submit, receive, or access electronic Medicare transactions on behalf of a provider. This matters whether the provider exchanges data directly with Medicare or works … Read More →
270/271 Eligibility Verification: Best Practices for Fewer Denials and Faster Answers Before a claim ever gets submitted, there’s a question that determines a lot of what happens next: is this patient actually covered? The 270/271 transaction pair is how that question gets answered electronically — the 270 is the eligibility inquiry a provider sends, and … Read More →