Lesson 3 Summary
- EDI is the automated paperless transfer of health care data in a standard format between Medicare and providers, often using a billing service or clearinghouse
- All providers must enroll and register with Medicare EDI before performing transactions directly or through a billing service or clearinghouse
- HIPAA requires you to submit all electronic claims using the X12 837 format
- All HIPAA-covered health care providers must get an NPI
- Providers billing electronic claims must comply with the ASC X12N implementation guides
- Companion guides offer more specific information on 837I electronic claim loops and segments