Electronic Data Interchange (EDI)

No cost, all payer claims submission*

Sustain growth with every claim and benefit, from automation within an enriched EDI data stream.

Remove the claim submission cost barrier.

Submit all commercial payer and Medicare claims for free. Optum® Intelligent EDI takes out the cost for providers to submit claims to health plans by providing complimentary claim file management. From a single dashboard, upload, track and manage claims to help ensure the most timely and accurate payments. *Minimal pass-through and select Medicaid payer fees apply.

Achieve higher first-pass payment rates.

Submit clean claims to reduce denial rates and A/R days — and increase collection rates. Optum Advanced Clinical Editing, available within the EDI stream, allows organizations to correct coding errors prior to entering the payer’s adjudication system.

Automate clinical documentation exchange.

Our compatibility with the industry’s top technology vendors, including streamlined integration with Epic, enables organizations to maximize their current investments and ensure claims are routed within their current electronic workflow. 

Customize EDI with in-stream capabilities.
  • Claims submission and tracking (free*)     
  • Claims status inquiry (free*)
  • Referral authorization (optional module, additional fees apply)
  • Electronic remittance (free)
  • Dashboard view (free)
  • Eligibility and benefits checking (optional module, additional fees apply
  • Advanced clinical editing (optional module, additional fees apply)
  • Patient statements (optional module, additional fees apply)
  • Contract management (optional module, additional fees apply)

 

* Minimal pass-through, select Medicaid payer, and non-UHC real-time fees apply to some transactions.

 


“Saves time within the revenue cycle process by identifying coding edits prior to claim submission, reducing required time and resources.”

– Lisa Marie Saldivar, RHIT, CCS-P, Coding & Reimbursement Manager, DuPage


 

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