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 UnitedHealthcare Provider Portal, once registration is complete. Follow steps below to sign up for iEDI:
Register online for a One Healthcare ID by creating a username, password and answering security questions. Skip to step 2 if you already have a One Healthcare ID.
Request setup for iEDI to be added to your UnitedHealthcare Provider Portal dashboard.