UnitedHealth Group EDI

UnitedHealth Group EDI solution in health care industry partnership

Using Electronic Data Interchange (EDI) to exchange information with UnitedHealth Group EDI department and other payers has many advantages. Take a look at the benefits and savings below to see how UnitedHealth Group EDI initiative may benefit your practice.

Send and receive information faster. With UnitedHealth Group EDI, providers typically experience quicker turnaround times. For example, a payer can receive your claim the same day you send it. An eligibility inquiry can be received and responded to in seconds.

Identify errors and avoid delays. Electronic claims are automatically checked for HIPAA- and payer-specific requirements at the vendor, clearinghouse and payer levels. This process decreases the number of reasons a claim may be rejected. This same level of automated data verification cannot be performed on paper claims.

Exchange information with multiple payers. UnitedHealthcare EDI solution allows you to easily execute transactions for multiple payers at one time. Transactions can be set up to automatically generate as part of your daily workflow. For example, your system could concurrently send eligibility inquiries prior to a patients’ appointment date. This is made to verify their coverage and copayment while it is performing a claim status inquiry.

Go Green and reduce mail time, postal costs and paper. Payers receive electronic transactions in real-time. This eliminates both mail time and the cost of postage and envelopes. EDI is also good for the environment because it reduces the volume of paper you receive. Receiving electronic confirmation of claim submissions, electronic remittance advice (ERA/835), electronic funds transfer (EFT) and other UnitedHealth Group EDI transactions can save trees and time.

Lower your receivables. UnitedHealthcare EDI initiative may make a positive impact on your bottom line. Automating electronic transactions such as eligibility will enable you to have current coinsurance, deductible and benefit information readily available while the patient is present. All EDI transactions may help increase your cash flow and accuracy of information exchanged.

Cut administrative expenses. Whether it’s purchases you wish to avoid (paper forms, supplies and postage) or time you want to save from phoning, faxing, printing, sorting and stuffing envelopes, EDI may increase productivity and lower costs.

Spend less time on the phone. Many of the calls received by UnitedHealthcare can be answered by sending one of the following EDI transactions (UnitedHealth Group EDI initiative):

  • Eligibility (270/271)
  • Claim Status (276/277)
  • Notifications (278N)

The information returned comes from the same system used by representatives to answer calls. You can gain cost savings by reducing the amount of time spent on the phone.

Estimate Your Cost Savings from Increased Efficiency. A study by Milliman, Inc. calculated the cost of manual and electronic transactions for a typical physician practice. This analysis found that using EDI could reduce annual costs by more than $42,000 per physician. Although these savings may vary widely, they are good enough to justify greater use of electronic transactions.

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