EDI Technical Specs & Standards

Swiftivity®, powered by RMSOA, has the expertise to handle your billing clearinghouse and prior authorization software demands, bringing lower costs and better outcomes to all parties.

Electronic Data Interchange, or EDI, is a complex topic as well as an absolute necessity for healthcare, physician practices, and insurance companies to maximize patient satisfaction. If you’re unfamiliar with EDI technical specs and standards, we’ve outlined some of the common data formats and system integrations — augmented by our technical capabilities.

Technology at its Best

Technical Expertise Equals Customized EDI Solutions

Experience Swiftivity’s® Emailed Enabled eAuthorization Capabilities. We work with you to build a customized solution to meet your needs & requirements.

Swiftivity® is the solution.

There is not an EDI implementation we’ve encountered that hasn’t included a “super special legacy system” (or two) that required extensive customization and attention. Many practices are delaying the adoption of EDI clearinghouse solutions for claims processing/billing and workers’ comp prior authorization; some due to the estimated cost, others due to implementation hurdles — but Swiftivity® is here to help.

 

Common EDI Formats

  • 837/275 (Bill and Attachment)

  • TA1 999/997/824 (Acknowledgements)

  • 276/277 (Bill Status Inquiry/Response)

  • 835 (Remittance Advice)

  • 278 (Authorization Requests & Response)

Other EDI Formats

These are formats that can be utilized in a customized solution:

  • XML

  • Databases

  • XBRL

  • Flat files

  • Microsoft Excel

Technical Capabilities of
Swiftivity’s® EDI Clearinghouse
Solutions

  • Any-to-any data mapping

  • Conversion & transformation

  • Enterprise integration

  • Infrastructure, application & data redundancies to support continuity & disaster recovery

  • Reduced delays to promote more efficient two-way communication

  • Swift delivery to information receivers

 
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Prior Authorization
Solutions

Expedite authorizations, digital delivery, and enhanced automation with our easy to implement workers’ comp prior authorization software. Experience quick resolution of RFAs, a comprehensive audit trail, and increased efficiency.

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Workers’ Comp EDI
Solutions

Achieve simplified and more accurate medical claims, EMR/EHR attachments and payments at cost savings with EDI integration from Swiftivity®. We are masters of the payment process and we specialize in workers’ comp and auto medical billing.