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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: EDI Support
PO Box 3620
Akron, Ohio 44309-3620
Fax: 330.996.8877

Apex Health Solutions
Attn: EDI Support
PO Box 3620
Akron, Ohio 44309-3620
Fax: 330.996.8877

For Vendors/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. 

835 Registration Form

EDI Employer Registration Form

Electronic Fund Transfer Form

Trading Partner Agreement

Trading Partner Change Form

Vendor FTP Registration Form

HIPAA Companion Guides

277CA Companion Guide

834 5010 Companion Guide

835 5010 Companion Guide

837 5010 Institutional Companion Guide

837 5010 Professional Companion Guide

Questions?  We are here to help.

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If you have not met with your assigned Provider Engagement Specialist or would like to schedule an in-office training or meeting to address any questions regarding the authorization process, claims issues, appeals, SummaCare products/benefits or Plan Central training, please contact the assigned Provider Engagement Specialist for your office.

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View patient eligibility, benefits, claims status, and self-funded prior authorization lists, as well as review clinical edits and clarifications.