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The 834 is used to transfer enrollment information from the sponsor of the insurance coverage, benefits, or policy to a payer. The format attempts to meet the health care industry's specific need for the initial enrollment and subsequent maintenance of individuals who are enrolled in insurance products.
In November 1991, the Workgroup for Electronic Data Interchange (WEDI) was established in response to the challenge from the Bush administration, specifically, Louis Sullivan MD, Secretary of HHS, to reduce administrative costs in the nation's health care system by up to 10%.
For an "inbound" document, the EDI solution will receive the file (either via a value-added network or directly using protocols such as FTP or AS2), take the received EDI file (commonly referred to as an "envelope"), and validate that the trading partner who is sending the file is a valid trading partner, that the structure of the file meets ...
Medical billing, a payment process in the United States healthcare system, is the process of reviewing a patient's medical records and using information about their diagnoses and procedures to determine which services are billable and to whom they are billed.
Change Healthcare Inc. (known as Emdeon before rebranding in 2015, which followed its acquisition of Change Healthcare) is a provider of revenue and payment cycle management that connects payers, providers, and patients within the U.S. healthcare system. [2]
an interactive exchange protocol (I-EDI) standard messages which allow multi-country and multi-industry exchange The work of maintenance and further development of this standard is done through the United Nations Centre for Trade Facilitation and Electronic Business ( UN/CEFACT ) under the UN Economic Commission for Europe, in the Finance ...
In U.S. health insurance, a preferred provider organization (PPO), sometimes referred to as a participating provider organization or preferred provider option, is a managed care organization of medical doctors, hospitals, and other health care providers who have agreed with an insurer or a third-party administrator to provide health care at ...
GS1 EDI is a set of global electronic messaging standards for business documents used in Electronic Data Interchange (EDI). The standards are developed and maintained by GS1 . [ 1 ] GS1 EDI is part of the overall GS1 system, fully integrated with other GS1 standards, increasing the speed and accuracy of the supply chain.
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