Electronic Data Interchange

Electronic Data Interchange (EDI) is the automated transfer of data in a specific format following specific data content rules between a health care professional and Medicare or between Medicare and another health care plan. A clearinghouse or billing service that represents a health care professional or another payer can help with the transfer.

EDI transactions are transferred via computer to or from Medicare. EDI helps Medicare and health care professionals process transactions faster and at a lower cost.

You must submit initial claims for payment to Medicare electronically unless you qualify for a waiver or exception.

Call your region’s EDI Helpline for more information.