Establishing an EDI connection with UnitedHealthcare has never been easier. Learn more about the benefits of EDI. You can use EDI for:
- Claims submissions (837)
- Eligibility and benefits (270/271)
- Claims status (276/277)
- Referrals and authorizations (278)
- Hospital admission notifications (278N)
- Electronic remittance advice (835/ERA)
EDI transactions can be submitted to multiple payers from your Practice Management System (PMS) or Hospital Information System (HIS) through a clearinghouse. Some clearinghouses offer online solutions that allow you to upload data from your software system or manually enter the information online to generate a transaction.
- Clearinghouse: You can use any clearinghouse with a connection to UnitedHealthcare for EDI transactions. Before choosing a clearinghouse, review EDI Clearinghouse Options to:
- Help determine the EDI needs of your practice or facility
- Avoid clearinghouse fees if UnitedHealthcare is considered a non-participating payer
- Optum Intelligent EDI (iEDI): A multi-payer web service and clearinghouse solution for all your EDI transactions. Submit transactions directly to Optum by using data from your PMS or HIS or manually enter the data using direct data entry (DDE) online. DDE can be used for professional (CMS-1500) claims and institutional (UB04) claims, as well as other EDI transactions. Optum Intelligent EDI is free* for UnitedHealthcare transactions and simplifies the process from patient check-in to payment posting. It is accessible through Link, once registration is complete. Follow steps below to sign up for iEDI:
*Excludes Harvard Pilgrim, The Alliance and NDC Home Infusion Specialty Pharmacy Claims
UnitedHealthcare Payer Lists
EDI transactions are routed to payers using a Payer ID based on the transaction type. Payer IDs can be found on our payer lists.
- Claims Payer List: Indicates Payer IDs to use for EDI 837 claim submissions
- ERA Payer List: Indicates Payer IDs to use for EDI 835 ERA delivery directly to your PMS or HIS
View Understanding Payer IDs for more information.