E
Definition
The standard file format used for computer-to-computer exchange of healthcare documents.
Overview
Why it Matters
This is the "language" your software speaks. If you want to automate billing, you must understand EDI.
How it Works
Your software compiles data into an 837P text string and uploads it to the clearinghouse.
Code Comparison
Comparison: EDI vs. API
EDI: Old school, batch processing, standard across all US healthcare.
API: Modern, real-time, varies by company.
Common Questions
- Formatting Errors: One missing character in an EDI file can cause the entire batch of 500 claims to fail.
- Use a "Clearinghouse" that validates your EDI files before they go to the payer.
Sources
X12 - EDI Standards