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Eligibility and Claims

EDI: What is it?

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. 

The Benefits of EDI

  • 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

For more information regarding EDI and electronic billing requirements, click on the following links:

If you are not submitting your own claims, please forward the guide to your clearinghouse or whoever else is responsible for your transactions.

For more information

  • HIPAA Project Manager (Privacy Contact): 215-991-4216
  • Provider Services Helpline: 1-888-991-9023