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EDI 275

What is an EDI 275?
EDI 275 is an Electronic Data Interchange transaction you can use to submit additional information related to a claim, instead of using mail or fax. Unsolicited attachments are those you send us that we didn’t request. They can be sent for claims that are likely to result in a request for additional information. Solicited attachments are those where we request additional information, when needed, to process a claim.

Two ways to send information

  • Directly from practice to payer
  • From practice to clearinghouse to payer

Benefits

  • Provides electronic acknowledgment and proof of delivery/receipt
  • Eliminates requests from us for supporting documentation
  • Removes the need to copy and mail information
  • Cuts out the need to drop claims to paper when attachments are needed
  • Prevents added delays by allowing submission of additional information needed at the time of claim submission
  • Increases productivity and efficiency

Common claims needing additional medical documentation (attachments)

  • Medical necessity determinations (e.g., cosmetic, medical policy or by procedure code)
  • Supporting therapy treatments
  • Unlisted procedure codes that describe the name of the procedure/service performed or billed
  • Air ambulance transportation details
  • Reasoning for durable medical equipment (DME) supplies
  • Operative notes for services performed by a co-surgeon

Getting started

We want to make working with us easier, which includes the ability to submit all the information electronically.

Current EDI 275 availability
In partnership with our affiliate Optum, we’re working to add more clearinghouses that can accept unsolicited EDI 275 claim attachments. Currently, the clearinghouse Jopari has this capability.

If your organization is currently working with Jopari, please contact them directly to get started. 

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