HealthCare EDI Solutions - 837 / 835 HIPAA Compliance

Pro_EDI has been helping small doctor’s offices and large insurance companies become EDI enabled since the new HIPAA regulations took effect in the 1990s. Third Party Billing Providers have also embraced the ability to become EDI compliant to handle their client’s claims through Pro_EDI’s easy to use software. Whether you need to handle Electronic Claim Filing (837s) and Electronic Remittance Processing (835s) for one or dozens of Trading Partners, we have a solution to fit your needs.

Doctor’s Offices

Larger offices can integrate Pro_EDI with their billing systems via the importing / exporting of flat files to your specialized software. Our team can write these healthcare maps for you, or your own IT staff can create as many maps as needed for your expanding office with no extra charges. We also offer unlimited phone and Email support options, and can assist you with integration as well.

Smaller practices may benefit from having our experts write the maps tailored to your trading partner’s needs. This saves your staff time, while ensuring a quick hassle-free EDI implementation. We have 837 and 835 templates available that may accommodate certain clients at a reduced cost.

Insurance Companies

Insurance Agencies like Anthem Blue Cross trust Pro_EDI to handle their large volume of daily EDI transactions. The low setup costs and expandability make Pro_EDI ideal for larger organizations who are continually adding new customers or have to change EDI standards occasionally without worrying about costly fees. Our system is robust enough to satisfy the requirements of fortune 500 companies, but so easy to use that they recommend Pro_EDI to their smaller trading partners.

Third Party Billing

3rd Party Billing Service Providers also enjoy the quick implementation times for their insurance claims processing. Easily integrate EDI with your in-house billing software to minimize data re-entry with Pro_EDI and reduce errors which helps to lower overhead costs. EDI compliance is a great value add-on component for Service Bureaus aiming to assist their clients with medical claims and insurance benefits.

Whether you're a small organization just delving into EDI, or a large organization looking to migrate to a new system to save money - we have you covered. Pro_EDI can handle any EDI x12 or EDIFACT transactions that can come your way. Most common among the health insurance industry are:

  • 837P - Healthcare Claim Professional
  • 837I - Healthcare Claim Institutional
  • 837D Healthcare Claim Dental
  • 834 - Benefit Enrollment and Maintenance
  • 835 - Healthcare Claim Payment/Advice
  • 270/271 - Healthcare Eligibility, Coverage or Benefit and Information Response
  • 277/275 - Healthcare Claim Request for Additional Information and Response
  • 276/277 - Healthcare Claim Status Request and Response
  • 820 - Payroll Deducted and Other Group Premium Payment for Insurance Products
  • 278 - Healthcare Services Review - Request for Review and Response

Have additional EDI HealthCare questions? We can help you select the Solution that best fits your needs and answer any technical or pricing questions you may have. Call or email us today at 1.800.969.3341!