The benefits to care providers:

• Reduce expense related to redundancy and manual functions for the claim submission process and cost associated with mailing claims.
• Sending and receiving information faster turnaround times are typically quicker than using manual processes allowing for quicker re-imbursement.
• Identifying submission errors immediately and avoiding claim processing delays electronic claims are automatically checked for HIPAA and payer-specific requirements at the vendor, clearinghouse, and payer levels. This process decreases the reasons a claim may be rejected by the payer. This same level of automated data verification can’t be performed on paper claims.
• Lowering account receivables electronic transactions, such as the eligibility transaction, provides the patient’s current coinsurance, deductible, and benefit information when they’re in for an appointment and before the claim is submitted to the payer for processing. This allows the care provider to collect a copayment at the time of service.
• Spending less time on the phone EDI reduces calls your staff needs to make to insurance carriers to obtain information on members, claims, claim payments, authorizations, and referrals.
• Exchanging information with multiple payers EDI lets you complete transactions for multiple payers at one time. Transactions can be set up to automatically generate in a practice's daily workflow.