Healthcare EDI Solutions

EDI is essential for the healthcare industry, enabling secure and efficient exchange of critical data between providers, payers, and other stakeholders. ProEDI offers a robust, flexible, and cost-effective EDI solution tailored to meet the evolving needs of healthcare organizations. Our software ensures full compliance with HIPAA standards, making it easy for your organization to meet regulatory requirements.

Key EDI Standards in Healthcare

In the United States, the Health Insurance Portability and Accountability Act (HIPAA) mandates the use of specific EDI standards for healthcare transactions. These include the ASC X12 standards, which cover critical transactions such as:

  • 835: Health Care Claim Payment/Advice
  • 837P: Health Care Claim (Professional and Institutional)
  • 277: Health Care Information Status Notification
  • 278: Health Care Services Review Information
  • 834: Benefit Enrollment and Maintenance
  • 270: Eligibility, Coverage or Benefit Inquiry
  • 271: Healthcare Eligibility/Benefit Response

ProEDI fully supports all required HIPAA transactions, ensuring that your organization can seamlessly exchange data with trading partners while maintaining compliance with federal regulations.

Benefits of ProEDI for Healthcare EDI

ProEDI is trusted by leading healthcare organizations, including insurers like Delta Dental Plan and Destiny Health, as well as providers such as Ascension Health Woodlands and Susquehana Health System. Our solution offers:

  • HIPAA Compliance: Fully supports all required HIPAA EDI transactions, ensuring you meet regulatory requirements.
  • High-Volume Processing: Handles large transaction volumes, with benchmarks showing files as large as 200 megabytes generating over one million records in under seventy-five minutes on a standard Windows platform.
  • Flexibility: Easily maps and translates EDI transactions, including 837s, to integrate with your existing systems.
  • Scalability: Designed to handle growing transaction volumes and adapt to changing industry requirements.
  • Cost-Effective: A scalable solution that reduces administrative overhead and minimizes errors.

Why Choose ProEDI?

ProEDI simplifies HIPAA compliance and streamlines your healthcare data exchange processes. Whether you’re managing claims, eligibility inquiries, or benefit enrollments, our software provides the tools you need to operate efficiently and securely. Plus, our dedicated support team is here to help you every step of the way.

Get Started Today

Ready to enhance your healthcare EDI processes? Contact our team today to learn more about how ProEDI can meet your needs. Request a free demo to see our solution in action!

Email or call us at 1-800-969-3341 for a free cost analysis