Electronic Data Interchange (EDI) Modules

SoftAid's electronic data interchange (EDI) modules can help your organization significantly reduce costs by replacing manual, paper-based transactions with electronic claims processing. Your EDI transactions are secure and conform to the standardized system that was developed under the HIPAA mandated guidelines of the American National Standards Institute (ANSI), the coordinator for national standards in the United States.
 

Advantages of Using EDI

• Significantly reduce the manual labor costs of claim submission, eligibility and payment.
   
• Reduce denials due to error with claim scrubbing, providing a 97% to 100% error free acceptance rate.
   
• Virtually eliminate denials do to eligibility.
   
• Improve reimbursement by optimizing claim coding with a unlimited variety of insurance company fee schedules.
   
• Increase cash flow with faster payments, sometimes by as much as 14 to 21 days.
   
• EDI submitted claims are easier to track and provide a detailed electronic record of what was paid and what remains outstanding.

EDI formats include:

• ANSI 837p (professional claims)
• ANSI 837i  (institutional claims)
• ANSI 835   (payment/remittance advice)
• ANSI 270/271  (eligibility status)
• NSF 2.0  (for legacy systems)

EDI modules can be used to transmit to the following payers:

• Medicare A
• Medicare B
• DMERC regions A, B, C, and D
• Medicaid
• THIN
• WebMD
• ProxyMed
• ENS
• Any commercial carrier who can accommodate direct electronic transactions

 
Direct EDI prices and availability vary geographically. Testing may be required by payers. Please check with your SoftAid representative for more information.

• Electronic claims submission
• Electronic remittance advice
• Eligibility
• Credit card services
• Check authorizations
• Patient statements

• Envoy (WebMD)
• Electronic Network Systems (ENS)