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EDI 834

EDI 834: Benefit Enrollment Transaction

Healthcare industry businesses are constantly faced with large amounts of data that require accurate and timely input to allow documents to be transferred between partners. The EDI 834 transaction is used by government agencies, employers, and health plans to enroll and maintain membership in a healthcare benefit plan. The EDI 834 is used for functions, such as:

  • Adds - New Enrollments
  • Changes - Changes in a member’s enrollment
  • Reinstatement - Reinstatement of a member
  • Termination - Disenrollment of a member

Manual input of this data often time-consuming and results in data errors.

At Effective Data, we offer complete healthcare EDI solutions. When using our EDI integration process, the EDI 834 is created with a zero risk of data entry and is done in a secure, time-efficient process. We are dedicated to providing secure and flexible healthcare EDI systems that increase accuracy, security, and timeliness.

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Creating the benefits enrollment EDI can either done by manually entering the information into an EDI standard document or pulling the information through data integration by your in-house EDI system.

This data typically includes information such as:

  • Subscriber eligibility
  • Service Identification
  • Subscriber name and information
  • Plan Network Identification

Once this data has been entered, either manually or by data integration, into the EDI translator, it will begin the conversion process into an EDI 834 document. This conversion process follows strict guidelines set into place by ASC X12 and meets HIPAA-based EDI requirements maintained by the TR3 schema.

We understand that ensuring that the EDI 834 document is sent securely and timely is critical. These documents contain vital information that can impact multiple parties.

EDI 834 are most commonly sent directly to the recipient, but they can also be sent via dial-up to a Value-Added Network in a secure form and then redirected to the recipient. Once the recipient receives the EDI 834, they must respond with a 999 Implementation Acknowledgement.

At Effective Data, we support all major EDI communication methods while maintaining knowledge of changing industry standards and trends. We understand that the management of patient documents is of critical importance and requires absolute security.

We specialize in helping healthcare industry businesses securely automate and improve processes while maintaining compliance with all healthcare requirements. Our services include:

  • Cloud EDI
  • Off-premise EDI
  • On-premise EDI
  • Hosted EDI
  • EDI Assessment
  • HIPAA Level-7 Integration
  • Strategy Consulting
  • Process Automation
  • VAN Services
  • And More

We offer full-service, one-on-one support for all of your needs.

To improve patient care by maximizing security and productivity with HIPAA compliant EDI services, contact us here for more information.

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