How to use EDI to exchange information with us electronically

Who is this for?

Provider Help |

If you're a provider, facility, software vendor or clearinghouse, this will help you learn how to reduce costs and save time by sending and receiving information electronically.

EDI, or electronic data interchange, is the paperless way to exchange information via computer. The information can be things like claims, electronic enrollment, patient eligibility and claims status transactions.

In order to send and receive information using EDI, you'll need to get set up and follow some guidelines. We'll help you do that here. You'll also find lists of claims that can't be processed electronically and a library with helpful documents.

Submitting claims and other transactions: Getting started

To learn how to submit claims and other transactions to us electronically, please select the option that most closely describes you.

EDI agreements

You can use these links to complete or update the required EDI submitter and provider agreements.

Claims that can't be processed electronically

Not all claims can be processed by our various system areas. Please select the link below that applies to you to see a list of claim exclusions.

How to get eligibility and claims status information electronically

We have two ways for providers to get patient information electronically:

How to set up and test enrollment files electronically

Want to manage health care enrollment electronically? Learn how to set up, test and use electronic enrollment.

Reference library

If you've already completed our EDI set-up process, you may need to review some information from time to time. Start by selecting your line of business.