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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 EDI questions

Call our Claims EDI Support line at 215-991-4290 or 1-888-991-9023.

For more information

  • Claims Technical Support (EDI/Transaction Contact) 215-991-4290
  • HIPAA Project Manager (Privacy Contact) 215-991-4388
  • Provider Service Helpline 215-991-4350 or 1-888-991-9023