University Of Utah Health Plan EDI General Data And Guides
University Of Utah Health Plan EDI program offers significant benefits for both providers and payers. Electronic claims can help improve efficiency, productivity and cash flow for providers, while payers can see benefits in reduction of data entry errors and faster turnaround times.
Of the claims that University of Utah Health Plans receives electronically, 80% pass through the claims processing system without processor intervention. The average turnaround time for University Of Utah Health Plan EDI claims (received date to check being received in the provider office) is 15 days.
University Of Utah Health Plan EDI Transactions Accepted
University Of Utah is currently accepting the following HIPAA-compliant transactions:
- 837 005010X222A1 (Professional claims)
- 837 005010X223A2 (Institutional claims)
- 277CA Claim Acknowledgement/error report
- 999 Acknowledgement
- 835 005010X221A1 (Remittance advice)
- EFT (Electronic funds transfer) in conjunction with the 835
- COB (Coordination of Benefits)
- 270/271 0051010X279A1 Eligibility Request/Response (real time)
- 276/277 Claim status inquiry/response (real time)
In compliance with CORE requirement 270 University Of Utah uses the UHIN clearinghouse for all EDI transactions.
Utah Health Information Network
University Of Utah Health Plan is a member of the Utah Health Information Network (UHIN), a non-profit coalition of payers and providers in Utah. University Of Utah Health Plan members have come together to reduce the administrative costs of health care through standardizations of electronic interactions.
University Of Utah Health Plan currently administers the following plans:
- Healthy Premier- Group
- Healthy Preferred- Group
- Medicaid Products
- Healthy U Traditional Medicaid
- Healthy U Non-Traditional Medicaid
- HOME (Healthy Outcomes Medical Excellence)
- Healthy Advantage Plus HMO
- Healthy Advantage (HMO) Medicare Plan
- University of Utah Employee Health (University Health Care Plus)
- University of Utah Health Plans Marketplace
- Healthy Premier Individual & Family Plans
- UNI-BHN Carve-Outs (mental health claims only).
All HIPAA-compliant EDI transactions with University of Utah Health Plans must be submitted through the Utah Health Information Network (UHIN). Before University of Utah Health Plans can process transactions, the submitting trading partner must obtain a trading partner ID and complete enrollment for services through UHIN.