You can have speed, convenience and lower administrative costs through Electronic Data Interchange (EDI) or electronic claims processing. We utilize Smart Data Solutions (SDS) as our clearinghouse.
To take advantage of this service, contact your billing software vendor and request that your claims be submitted through (SDS). You can also contact SDS directly. All trading agreements come through them exclusively. You can contact them directly at stream.support@sdata.us in order to set up a trading platform with us.
Be sure to include the following information: first name, last name, email, phone, organization name, organization NPI, organization Tax ID, and which payer claims will be submitted to:
- Health Partners Plans Medicaid / CHIP / Jefferson Health Plans Medicare Advantage HMO / Jefferson Health Plans Individuals and Family: Payer ID# 80142
- Jefferson Health Plans Medicare PPO: Payer ID# RP099
- Jefferson Health Plans New Jersey Medicare PPO: Payer ID#NJ099
Electronic Data Interchange (EDI) is the sending and receiving of information using computer technology. Any standard business document that one company would exchange with another, such as a purchase order, invoice, shipping schedule, inventory inquiry and claim submission, can be exchanged via EDI between the two parties, or trading partners.
- Reduced administrative costs
- Higher claim acceptance rates
- Data moves faster and with greater accuracy
- Increased productivity
- Audit trail of claims submissions
- Elimination of paper documents
- Elimination of labor-intensive tasks, such as data entry
- Greater accuracy of information
If you are not submitting your own claims, please forward the guide to your clearinghouse or whoever else is responsible for your transactions.
Still have questions regarding EDI processing? If you are a health care professional with questions, or are interested in becoming an electronic biller, feel free to email our Claims Department (EDI) Support line at EDI@jeffersonhealthplans.com. Our EDI Analysts will be glad to contact you, typically via telephone.
Please keep in mind, this is not the place for vendors, physicians or health care professionals to send questions regarding claim payments. If you have questions regarding claims, call our Operations Technical Support - EDI/Transaction Hotline at 1-215-991-4290 or the Provider Service Hotline at 1-888-991-9023.