What is Electronic Data Interchange (EDI)? EDI is the electronic transfer of information, such as electronic media health claims, eligibility inquiry and claim status inquiry, in a standard format between trading partners. EDI allows entities within the healthcare system to exchange medical, billing and other information and to process transactions in a fast and cost effective manner. With EDI there is a substantial reduction in handling and processing time compared to paper, and the risk of lost paper documents is eliminated.
EDI saves time, reduces cost and improves accuracy. SummaCare is pleased to provide EDI document processing for providers and employers.
If you plan to submit HIPAA transactions to SummaCare, please complete the appropriate form below and return to:
Attn: Compliance Department
1200 E. Market Street, Suite 400
Akron, Ohio 44305-4018
For Trading Partners: Each direct submitter must complete a Trading Partner Agreement. This Agreement includes trading partner obligations, term and termination, verification of eligibility, proprietary information, etc. that you must abide by in submitting information directly to SummaCare.
For Providers: Each provider must submit a Provider Registration form.
For Employers: Each employer must submit an Employer Registration form.
For Vendors: Each vendor must submit a Vendor FTP Registration form.
EDI Employer Registration Form
837 5010 Institutional Companion Guide
View patient eligibility, benefits, claims status, and self-funded prior authorization lists, as well as review clinical edits and clarifications.