Benefits of EDI and Real Time Claim Status

Table of Contents

• Benefits of EDI and Real Time Claim Status
• Real Time Claim Status and Response - A Faster Better Option

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Benefits of EDI and Real Time Claim Status

There are a number of advantages to enrolling and submitting claims online. Claims and other transactions submitted electronically process considerably faster than paper submission. For example, HIPAA-compliant electronic claims are held in the payment floor for 14 days whereas paper claims are held in the payment floor for 29 days.

Some of the other advantages of electronic submission include:

• Increased cash flow and lower administrative costs
• Ease of billing
• Added efficiency and accurate claims filing

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Real Time Claim Status and Response - A Faster Better Option

Receive your claim status response in minutes instead of hours. All you have to do is format your 276 claim status request to contain one inquiry per transaction (ST-SE). Files containing multiple inquiries per transaction (ST-SE) will be routed through the batch process.

Please note that the real time process will run during the existing claim system availability on regular business days. The process will not be available on weekends and holidays. Files eligible for the real time process received during off hours will be held and processed when the systems become available. Any 276 file containing a request with a Claim Service Date span greater than a year will be routed through the batch process. Any 276 file containing a request with a Claim Service Date span greater than a year will be routed through the batch process.

Reviewed 9/23/2024