Title: What is Electronic Data Interchange in Healthcare?
Headings: What is Electronic Data Interchange in Healthcare?
What is Electronic Data Interchange in Healthcare?
How EDI in healthcare works
Benefits of EDI in Healthcare
Standardization
Cost savings
Security
Improved productivity
Faster processing
Data-centric healthcare EDI
Looking Ahead

Content: The enactment of HIPAA was intended to address these gaps. Healthcare data began to be transmitted in standard formats — primarily via the electronic data interchange (EDI) protocol X12 or EDI. Enabling HIPAA EDI transactions helped address security and compliance issues and fill other gaps such as information inaccuracy and patients’ lack of access to their healthcare information. Understanding electronic data interchange in healthcare – how it works, what are its benefits, and what are the key considerations for implementation – can help healthcare professionals and organizations fully capitalize on it. How EDI in healthcare works
Electronic data interchange in healthcare allows the exchange of computer-processable healthcare data in a standardized format and secure manner among healthcare professionals, healthcare institutions, and patients. For example, it enables healthcare providers to send claim status requests and obtain information using a standard transaction set for organized, compliant information exchange. Electronic data interchange healthcare transactions, however, are not email exchanges; they involve all electronic transmission of healthcare data between computer systems and applications. Different modes of healthcare EDI transactions delivery include “ web-based EDI, point-to-point EDI, mobile EDI, EDI VAN, and EDI via AS2 .” Healthcare EDI uses standard transaction sets such as EDI Health Care Claim Transaction Set (837), EDI Health Care Claim Payment/Advice Transaction Set (835), EDI Benefit Enrollment and Maintenance Set (834), EDI Health Care Eligibility/Benefit Inquiry (270), and EDI Health Care Claim Status Request (276).