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EDI provides a technical basis for automated commercial "conversations" between two entities, either internal or external. The term EDI encompasses the entire electronic data interchange process, including the transmission, message flow, document format, and software used to interpret the documents.
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.
An electronic remittance advice (ERA) is an electronic data interchange (EDI) version of a medical insurance payment explanation. It provides details about providers' claims payment, and if the claims are denied, it would then contain the required explanations. The explanations include the denial codes and the descriptions, which present at the ...
An electronic data interchange personal identifier, or EDIPI, is a number assigned to a record in the United States Department of Defense's Defense Enrollment and Eligibility Reporting System (DEERS) database. A record in the DEERS database is a person plus personnel category (e.g. contractor, reservist, civilian, active duty, etc.).
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.
XML/EDIFACT is an Electronic Data Interchange (EDI) format used in Business-to-business transactions. It allows EDIFACT message types to be used by XML systems. EDIFACT is a formal machine-readable description of electronic business documents. It uses a syntax close to delimiter separated files.
In July 1992, WEDI published a report that outlined the steps necessary to make electronic data interchange (EDI) a routine business practice for the health care industry by 1996. The Workgroup envisioned the entire health care industry transacting business electronically, under a nationwide set of coding and format standards for all transactions.
The EOB is commonly attached to a check or statement of electronic payment. An EOB typically describes: the payee, the payer and the patient; the service performed—the date of the service, the description and/or insurer's code for the service, the name of the person or place that provided the service, and the name of the patient
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