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EDI In The Health Care Industry

724 Words3 Pages

EDI stands for Electronic Data Interchange which is the computer to computer exchange of business documents in a standard electronic format between business partners. EDI replaces postal mail, fax, and email. While email is an electronic way to communicate, the documents exchanged via email is a task an actual person has to take on instead of a computer. Having people involved slows down the processing of the documents and accumulates a lot of errors. Instead of having that issue documents can flow directly through to the appropriate application on the receivers computer and processing can begin immediately. A typical manual process involves lots of paper and people while EDI process has no people and no paper. When you send an EDI document …show more content…

These standards will encourage electronic commerce in the health care industry and make the process involved much easier. This decision will result in a huge burden taken off health care providers and health plans. Today, both parties have a variety of formats for electronic transactions. The Secretary Of Health And Human Services adopted standards that was left with no choice by the HIPAA, (1) health claims and equivalent encounter information (2) enrollment and disenrollment in a health plan (3) eligibility for a health plan (4) health care payment and remittance advice (5) health plan premium payments (6) health claim status (7) referral certification and authorization and (8) coordination of benefits. For those who fail to abide with the changes made will have penalties of not more than $100 per violation on any person. The total amount for one person every year may not exceed $25,000 for …show more content…

Reimbursement is also used in insurance, when a provider pays for expenses after they have been paid directly by the policy holder or another party. Some people in the health care industry really need their money, they rely on their reimbursement as income. An Electronic Health Record is an official health record for an individual that is shared among different facilities and agencies. EHR include information that’s personal such as your contact info, info about why you visited the doctor, your insurance information, reimbursements,. Etc. So if you do owe anything that will be notated in your records. Governments of many countries are working to make sure all citizens have standardized electronic health records and that all records include the same types of information. EHR provides accurate up to date, and complete information about patients at the point of care. Securely sharing electronic information with patients and other

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