Elec Data Interchange (EDI)

What is EDI?

Electronic Data Interchange (EDI) is the exchange of business transactions in a standardized format from one computer to another. Simplexmed helps its clients and providers to use this technology to communicate claims, electronic remittance, claims payment, eligibility, and other information, providing a paperless and efficient process.

Quicker claims payment, confirmation reports, and elimination of paper and associated expenses are just a few of the reasons why nearly 80% of Simplexmed claims are submitted electronically. Use of EDI transactions allows a provider to submit transactions faster and be paid for claims faster, and to accomplish this at a lower cost than is generally the case for paper or manual transactions. A recent study found that EDI claims processing reduces the average provider’s cost per claim by $3.56. With hundreds or thousands of claims filed each year, savings add up – letting you focus more of your valuable resources on the things that really matter.

EDI also gives you the tools you need to track electronic claims status, improve timely filing, and access daily accept/reject reports. This also means easier receivables and account reconciliation. Simplexmed has the following transactions available for providers through one of our approved clearinghouses: 837 electronic claim submission, 835 electronic remittance advice, and EFT payments.

Electronic data interchange

Electronic Remittance Advice (ERA) & Electronic Funds Transfer (EFT)

Electronic Remittance Advice (ERA)

Simplexmed has further streamlined medical billing processes to improve claims procedures. Providers can now register to receive Electronic Remittance Advices (ERA). These features streamline claim processing, reduce administrative work and improve provider satisfaction by reducing claims-related problems.

ERA files give providers details regarding multiple claims. ERA improves providers’ business office workflow by allowing the adjudicated claim information to be automatically posted to accounts receivable systems. Simplexmed will send an ERA to any provider who registers with Simplexmed and with a clearinghouse.

Electronic Funds Transfer (EFT)

EFT automates the distribution of funds into providers’ accounts using Automated Clearinghouse (ACH) processing. EFT is the electronic mechanism used to instruct Depository Financial Institutions (DFIs) to move money from one account to another. Many formats are available for the actual data in the electronic message, and different formats apply at each stage. EFT is safe, secure, efficient, and less expensive than paper check payments and collections.

Revenue Optimizer (RO)

Revenue Optimizer (RO)

We will optimize your revenue through practice web-portal development and online marketing, payout analysis.

Claim Preparation

Claim Preparation

Error-free claim preparation and validation based on information provided by the practice

Elec/Paper Claim Submission

Elec/Paper Claim Submission

Claims can be submitted either electronically or via paper mail where required

credentialing services

Credentialing Services

When you need essential credentialing data, and you need it immediately, Simplexmed is here to help you

Elec Data Interchange (EDI)

Elec Data Interchange (EDI)

End-to-end encrypted data transfer between payers and providers along with electronic fund transfer (EFT)

Patient Service

Patient Services

Patient calls, itemized electronic and paper statements, and toll-free patient helpdesk

Reporting

Reporting

Get all the relevant reports when you need them. Easy access to all reports with a single click

Coding Services

Provide services in implementation of ICD-10 & CPT codes, help in diagnosis and procedures

Payment Posting

Payment Posting

Faster and accurate claim submission results in timely payment posting to the providers

A/R Management

A/R Management

Timely follow-up with the payers to assure timely payments to the provider

Denial Management

Denial Management

Minimal denials with active web based charge entry system

Meaningful Use

Meaningful use: is using (MU certified) electronic health record (EHR) technology