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About Electronic Data Interchange (EDI)

Electronic Data Interchange (EDI) is the process of transmitting Medicare Part B claims by electronic means. Healthcare providers and suppliers apply to NHIC Corp. EDI, to receive a submitter ID number and a password. Once enrolled in EDI, providers can bill directly to Medicare, using their own billing software, or allow a billing agency, clearinghouse, or vendor to send electronic claims on their behalf.

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NHIC, Corp accepts electronic claims (837 transactions) for:
Medicare Primary Payer Claims
Medicare Secondary Payer Claims
Medicare Tertiary Payer Claims
In addition, to electronic claims, NHIC, Corp also accepts electronic Claim Status (276 transactions).

Benefits of EDI

• Improved cash flow – claims settle up to 50% faster
• 24-Hour claim transmission – send claims to Medicare 24 hours a day, 7 days a week
• Transmission security – a submitter ID and password are required to send claims
• Electronic Remittance Advice (ERA) option – no paper EOMBs to misplace or store
• Improved claim control –  find and correct errors for immediate resubmission
• Reduced office costs – save time and storage space
• ANSI X12 4010A1 standardized industry format – Centers for Medicare and Medicaid (CMS), mandated standard for EDI transmission 
• With Electronic Data Interchange (EDI) you can quickly make corrections and resubmit a new claim. For example if you receive the following error message on your Medicare Remittance Advise:
  *MA130 : “Your Claim contains incomplete and/or invalid information, and no appeal rights are afforded because the claim is unprocessable. Submit a new claim with the complete/correct information.”
  All you would need to do is make changes needed and send a new claim.
  Note: “Click Here” to refer to the educational articles for the instruction for Reopenings and how to resubmit your claim with a MA130 (Unprocessable) error message.

Support Staff

Call (877) 386-1056   Monday through Friday 8:00 AM - 4:00 PM

Contact EDI Support Staff with any questions you may have regarding electronic claims transmissions, Error Summary Reports, Electronic Remittance Advice, Carrier Assigned Bulletin Board Systems (CABBS), on-line validation reports, EDI Enrollment changes,  or new EDI enrollment.

All new electronic submitters and electronic submitters changing software vendors must transmit test claims successfully to NHIC before being allowed to transmit production claims. EDI Support will guide you through the testing process and ensure a successful transition to electronic billing.

EDI Support also provides advanced technical support to software vendors and other organizations seeking to implement new EDI transactions. If you need help downloading files, have questions about the Medicare NHIC Website, or would like to learn to use CABBS Electronic Mail, EDI Support is available to help you.

Call or Write:

NHIC Corp.

Attn:  EDI

P.O. Box 9104

Hingham, MA 02044

edinhic@hp.com

03/25/2010