Title: What Is Healthcare EDI and Why Does It Matter?
Headings: What Is Healthcare EDI and Why Does It Matter?
What Is Healthcare EDI and Why Does It Matter?
What Is Healthcare EDI?
Healthcare EDI and HIPAA Compliance
EDI and Data Integration Benefits for the Healthcare Industry
Accuracy:
Cost savings:
Start with the Low-Hanging Fruit

Content: By using specific standards designed for the healthcare industry, healthcare EDI reduces complexity for all parties. There are standard transaction sets for claims, payments, enrollment, eligibility inquiries, and claim status requests. A corollary step that worked to reduce complexity was the introduction of the National Provider Standard, which requires that each healthcare entity (including individuals, employers, health plans, and healthcare providers) have a unique ten-digit national provider identifier number (NPI). NPI numbers play a vital role in healthcare EDI transactions; you can only submit standard HIPAA transactions with your NPI. Before HIPAA, there were over 400 forms for processes, many of which were paper-based. EDI and Data Integration Benefits for the Healthcare Industry
EDI and related integration disciplines can positively impact the financial well being of healthcare organizations in the following ways: Standardization: Eliminates confusion and complexity caused by competing local or proprietary formats
All recipients receive messages in a clear and consistent format
Consistent formats mean staff no longer must spend trying to decode “foreign” message formats
Efficiency: Consistency leads to efficiency;