EDI 835 Healthcare Claim Payment/ Advice
The EDI 835 transaction is an electronic Healthcare Claim Payment/ Advice (also known as ANSI X12 EDI 835) that a standardized electronic medical transaction implemented by HIPAA (Healthcare Insurance Portability and Accountability Act). An EDI 835 Healthcare Claim Payment/ Advice is used by healthcare insurance companies to make payments, provide an explanation of benefits (EOB) or both to the healthcare provider, hospital and medical facility.
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- Healthcare suppliers can easily become EDI compliant, manage activity and fulfill orders within WebEDI
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- Healthcare providers can automate healthcare procurement and simplify vendor onboarding
- Enhances operational efficiencies for HIPAA claims processing
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EDI 835 Healthcare Claim Payment/ Advice specifications and key data elements include:
- Which healthcare claim charges were paid, reduced or denied
- Plan details of whether the plan and claim charges are toward copay, deductible, coinsurance, etc.
- Line item payments and how the payment was made (for example through a clearinghouse)
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Other Common X12 EDI Transactions
- (EDI 271) Healthcare Eligibility/ Benefit Response
- (EDI 276) Healthcare Claim Status Request
- (EDI 277) Healthcare Claim Status Notification
- (EDI 278) Healthcare Service Review Information
- (EDI 834) Benefit Enrollment and Maintenance
- (EDI 837) Healthcare Claim Transaction
View the most commonly used EDI transactions.
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explore integrationsDataTrans Solutions and Global Shop Solutions have worked together to successfully create a preconfigured, custom adapter which is designed to connect DataTrans cloud-based EDI and eCommerce environment with Global Shop ERP system providing a fully integrated EDI solution.
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Lunchskins
I personally have been working with Datatrans for over 10+. DataTrans services, customer support and tech capabilities/offerings are like no other. We just recently we migrated from QuickBooks Enterprise to QuickBooks Online. All I can say is WOW! They had us up an running in no time and communicated with us every step of the way. They are truly partners in every sense of the word. I will never use anyone else!
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AMG Engineering & Machining, Inc.
From the very beginning, the analyst that I was working with was very knowledgeable and supportive. Within a short amount of time your team was able to make customizations to allow us to better assist our customers. The WebEDI portal is a definite plus because it provides us with all of the detailed information that we need and it is very easy to navigate. Lastly, your customer support staff is simply amazing!! They provide us with the assistance we need in a timely manner no matter the situation. We look forward to continuing our partnership with DataTrans for years to come!!
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LatchPal by Happy Fig
We’re thrilled to be working with DataTrans; they provide wonderful customer service, understand our organization’s needs, and have delivered custom solutions to help us grow. DataTrans is a true partner in every sense of the word. So glad we’ve found them.
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