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 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.