Electronic Transactions
What is EDI?
Electronic Data Interchange (EDI) is a computer to computer exchange of standard business documents used for sending and receiving information electronically between trading partners - clients and vendors. EDI can make your business more efficient and your workflow more precise.
Why should you use EDI?
- EDI is easier, faster and more accurate than traditional paper billing practices when submitting claims and receiving payments via electronic fund transfer (EFT).
- EDI replaces the need to fax and mail paper documents. The electronic exchange of information is much less expensive than handling paper documents. Studies show that manually processing a paper-based transaction can cost up to $70 while processing an equivalent EDI transaction costs less than one dollar!
Use electronic transactions to:
- Save time and money
- Reduce administrative costs
- Reduce or eliminate data errors
- View and or print documents instantly
View our Electronic Transactions flyer (PDF).
Electronic claims may be submitted through many types of practice management software systems or via Internet file transfer protocol (FTP). You can also enroll with the billing service or claims clearinghouse of your choice.
Claims transaction options
- Batch transactions: Larger offices submitting batch transactions may use our electronic claims partner, Availity®, LLC (Availity)
- Non-batch transactions: Smaller practices may prefer to use Office Ally to submit electronic claims
Regence currently accepts the following American National Standards Institute (ANSI) X12 4010A1 transactions:
| Type |
Description |
Enrollment information |
| 837 |
Health Care Claim
- Professional
- Institutional
- Dental
|
To enroll, contact our electronic
claims clearinghouse partner, Availity,
or, for smaller practices, Office
Ally. |
| 835 |
Remittance Advice (View the list of recent enhancements) |
Contact Availity or Office Ally to enroll
|
| 270/271 |
Eligibility Request and Response |
Contact Availity to
enroll |
| 276/277 |
Claims Status Inquiry and Response |
Contact Availity to
enroll |
| 278 |
Referrals, Pre-certifications and
Pre-authorization Inquiry and Response |
Contact Availity to
enroll |
Note: Availity supports business-to-business (B2B) integration for eligibility and benefit inquiry transactions. Contact your practice management system vendor and ask if they support B2B transactions with Availity for Regence, or view the Availity technology partners list (PDF).
Paper use is costly, inefficient and prone to errors. Let's work together to address the dollars that can be saved today through simple steps like electronic claim submissions, payments and remittances. Sign up today!
Note: To print a PDF document, you need Adobe® Reader®. Download it now for free.
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