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Healthcare EDI Services

Optimize the transmission of vital documents among patient care partners with innovative healthcare-specific, HIPPA-compliant EDI solutions from Effective Data. We are EDI consulting and data integration specialists dedicated to providing a flexible, secure environment for quickly building connected healthcare ecosystems geared for multi-party collaboration and modern channels of patient collaboration.

Effective Data offers a cloud-based EDI service called ED Connect, which gives hospitals and healthcare organizations a simple way to automate their entire supply chain and improve operational efficiencies while lowering costs. It provides a flexible, secure environment for quickly building connected healthcare ecosystems geared for multi-party collaboration and new patient collaboration channels. Reach out to our EDI specialists today to learn more about how our EDI healthcare solution can help streamline your processes!

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Management of data such as patient history records, emergency services reports, and medication information is of critical importance to healthcare professionals. Key applications of healthcare EDI systems include the management of medical and dental patient databases, insurance reimbursements, clinical trials, and regulatory data.

Effective Data specializes in helping any healthcare industry business automate and improve processes as well as become compliant with trading partner and regulatory requirements. Our products and services make it easy and affordable to collaborate, transfer data, and integrate internal business processes.

  • Cloud EDI
  • On-premise EDI
  • Off-premise EDI
  • Hosted EDI
  • HIPAA Level 7 integration
  • VAN services
  • Strategy consulting
  • EDI assessment
  • Process automation
  • Full service, one-on-one support

Why use EDI for Healthcare?

Using EDI for healthcare transactions improves productivity by enabling high-level accuracy, efficiency, and speed.  From patient records to medication information and insurance claims, the healthcare industry is inundated with vast amounts of data.  Processing this information is a monumental task for healthcare professionals, especially since it comes from a range of sources and in different formats.

EDI can help your healthcare operation obtain:

  • HIPAA Level 7 compliance
  • Standardization 
  • Higher productivity
  • Greater security
  • Improved accuracy
  • Lower costs

EDI Transactions Used In Healthcare

Healthcare institutions must communicate regularly with an array of partners, from internal databases and insurance companies to outside specialists and service providers. Eliminate these tedious and error-prone processes with automated communication from Effective Data.

We support all major EDI communications methods and have extensive knowledge of industry trends and requirements. When partnering with us, EDI documents are readily available, easy to process, and hassle-free to manage. Common EDI transactions that healthcare industry professionals use daily include:

  • EDI 270: Health care eligibility/Benefit inquiry  - The EDI 270 transaction is a request sent by healthcare service providers to insurance agencies or government entities, including Medicare and Medicaid. The EDI 270 typically includes items, such as details of the sender, name of the recipient, information on the plan subscriber, & description of eligibility or benefit information.
  • EDI 271: Heath care eligibility/Benefit response - The EDI 271 transaction is used as a response to a 270 request inquiry for the subscriber's eligibility and benefit information.
  • EDI 276: Health care claim status request - The EDI 276 is a transaction to inquire about the status of a claim after it has been sent to a payer.
  • EDI 277: Health care claim status response - The EDI 277 transaction is used as a response to the EDI 276 inquiry about the update on the claim status that was sent.
  • EDI 278: Health care service review - The EDI 278 is sent from a healthcare provider to request authorization from a payer, such as an insurance company. 
  • EDI 820: Payment order or Remittance advice - The EDI 820 transaction is used to transfer payment data between businesses or to confirm payment details. 
  • EDI 834: Benefit enrollment and maintenance set - The EDI 834 transaction is used by government agencies, employers, and health plans to enroll and maintain membership in a healthcare benefit plan.
  • EDI 835: Health care claim payment/Advice transaction set - The EDI 835 is the electronic submission format used by healthcare insurance plans to make payments or to provide an Explanation of Benefits. The EDI 835 is specified by HIPAA 5010 requirements.
  • EDI 837: Health care claim transaction set - The EDI 837 is the electronic submission format of health care claim information that is structured to meet HIPAA requirements. An EDI 837 transaction is used alongside the EDI 835 transaction. 
  • EDI 997: Functional acknowledgment transaction set - The EDI 997 is a response to other EDI transactions to serve as an acknowledgment that the submitted EDI transactions have been received.  

Improve patient care by maximizing security and productivity with HIPPA compliant, healthcare-driven EDI services from Effective Data.

We’re on your side. Contact us below for more information.

We owe a debt of gratitude to Effective Data. They took a last-minute call before the weekend and a few days later, our EDI software was upgraded and ready for our go-live date. They were knowledgeable, thorough and timely. Effective Data will get our business from now on. T.D., EDI Coordinator, Leading National Pharmaceutical Supplier

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