Electronic Data Interchange (EDI) Claims

Electronic Data Interchange (EDI) is the electronic transfer of information in a standardized format between trading partners. It allows partners to exchange information and conduct business transactions in a faster and more cost-effective manner.

The Health Insurance Portability Accountability Act of 1996 Public Law 104-191 (HIPAA) was passed by Congress to reform the health care insurance industry and simplify health care administrative processes.

The standard transactions that are included within HIPAA regulations consist of standard electronic formats for enrollment, eligibility, payment and remittance advice, claims, health plan premium payments, health claim status, referral certification and authorization.

To register and/or submit an EDI claim to your local VA health care facility, please call 1-800-845-6592 or visit the website below.

Emdeon

While registering you will need the VA Fee programs payer IDs which include:

• 12115 for submission of medical claims.
• 12116 for submission of dental claims.
• 00231 for submission of any inquiry transaction.