EDI Healthclaims Network

EDI has historically been associated with the manufacturing and retail value chain.  While this is certainly where EDI found some of its earliest proponents, the EDI Healthclaims network has also become a significant proponent and user of EDI because of the significant cost savings, increased productivity and reduction of errors associated with the EDI Healthclaims network.  In it's most basic definition, an EDI Healthclaims network is an organization that uses EDI to enable the exchange of medical claims and bills directly between hospitals and their providers.  In this manner, the EDI Healthclaims network is very similar in scope and role to the EDI VAN and EDI Service Bureaus that operate in the retail value-chain.

How an EDI Healthclaims network Works

The basic operational process of the EDI Healthclaims network is rather simple.  At its most basic function the EDI Healthclaims network works very much like the US post office - allowing buyers and sellers to exchange health care information in an electronic means.  While this most basic definition might seem redundant, the biggest benefit of the EDI Healthclaims network is the electronic component, allowing hospitals and their vendors to exchange information in purely electronic means, eliminating manual data entry, minimizing mistakes and providing significantly faster turnaround times that manual processes allow.

How to Get Ready for the EDI Healthclaims network

Unlike in the retail world where the customer is king, EDI in the healthcare field is often driven or "mandated" by suppliers; specifically, large companies like Cardinal Healthcare and the pharmaceutical companies.  When smaller hospitals and hospital chains are required to being trading using EDI, they often don't understand the process and can have trouble getting started.  This is where the EDI Healthclaims network comes into play, allowing health care providers to find an efficient, easy to use and easy to adopt service that can make processing claims using EDI easier and faster.

Moving Away from the EDI Healthclaims network

Would a hospital ever move away from using an EDI Healthclaims network?  For some the answer might be no, but for hospitals that truly embrace EDI the long-term proposition of an EDI Healthclaims network can be rather expensive.  These organizations will often bring the use of EDI software in house in an effort to establish more direct relationships with their vendors, thereby bypassing the EDI Healthclaims network. 

Regardless of whether your organization ultimately uses an EDI Healthclaims network, the benefits of EDI are far too great not to at least explore the option.  Over time you will find that using EDI to process your healthcare claims reduces your costs dramatically while achieving a significantly higher accuracy rate and at the same time providing faster and better care to your patients.

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