Healthcare Electronic Data Interchange Speeds Up Clinical Operations

Author : rose fox | Published On : 29 Feb 2024

Let’s look at some EDI transaction sets - 

1. EDI Benefit Enrollment and Maintenance Set (834)   

This transaction set is applicable for use by unions, associations, and government agencies to enroll people into health plans with payers. 

1. EDI Health Care Claim Status Notification (277)

This particular transaction electronic data exchange set can be used by an insurance company or a legally permitted party to communicate the status of a healthcare claim or clinical visit to a physician or other authorized persons. Moreover, the 277 set is also used by the same entities to request further information on a said claim in order to help the procedure along. But it is to be noted that it can’t be used for posting about account payments.
 

1. EDI Functional Acknowledgement Transaction Set (997)

This is a particular transaction set that is used to outline the results of the syntactical analysis of documents that are electronically coded. The results of EDI tools for healthcare indicated by a set of acknowledgments whose control structures are defined using this transaction set. The documents that are encoded are bunched into certain functional groups that are used to outline the transactions for interchanging business data.

Solutions for Electronic data interchange health have become an integral part of the current medical industry. As the model of reimbursements moves towards a value-based system, we can expect newer innovations in solutions for EDI transactions in healthcare.