Tufts Health Plan EDI

Tufts Health Plan EDI mission – electronic solutions for healthcare needs

Tufts Health Plan EDI commitment surves for providing clients with the easiest and most comfortable service. From member eligibility status and benefit information to claim submission and clinical information, your office can dramatically improve administrative costs with less paper and less time on the phone. Tufts Health Plan EDI tools save time in your transactions with Tufts Health Plan and will help streamline your practice, reduce your administrative costs, and increase information security.

First of all, clients should consider the types of transactions their office conducts with Tufts Health Plan EDI. Then mention how Tufts Health Plan self-service tools can help reduce the administrative costs and enhance the efficiency. After this one can compare the technology options to select the channel that best suits client’s needs.

Tufts Health Plan’s secure website enhances customer service for providers by delivering the information you need. With Tufts Health Plan EDI, providers can submit claims and referrals electronically, and receive electronic remittance through PaySpan® Health.

Direct submission

For faster turnaround and more timely payment, providers can send their EDI claims directly to Tufts Health Plan. For direct submission, a provider’s billing system is set up to dial directly into the claims system at Tufts Health Plan. Direct claim submission also includes direct support with a Tufts Health Plan EDI analyst for quick resolution of any EDI issues. There are no charges for direct claims submission.


With Electronic Data Interchange (EDI), providers can submit claims electronically – either directly or through a clearinghouse – and receive electronic remittance from Tufts Health Plan. Tufts Health Plan accepts EDI claims from all major clearinghouses. Providers send one electronic file for all of their claims to the clearinghouse. The clearinghouse, in turn, distributes those claims to all of the payers. There is usually a fee associated with using a clearinghouse.


Leave a Reply

Your email address will not be published.

Post Navigation