Electronic Data Interchange (EDI) is a set of standards for structuring information to be electronically exchanged between and within businesses, organizations, government entities and other groups. There are variety of network for each industry where EDI is used. These networks are used to exchange information that would traditionally be exchanged between two parties. Another term is electronic commence which is widely used to describe the paperless exchange of information or data. EDI allows transactions to be exchanged between computer from one organization to computer of another organization. EDI helps the paperless industry to be more organized by mandating the industry standards like HIPAA in healthcare.
Electronic Data Interchange (EDI)
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires that Medicaid and all other health insurance payers in the United States comply with the Electronic Data Interchange (EDI) standards for health care as established by the Secretary of Health and Human Services.
- Understand and justify the role of the EDI resource in the healthcare IT domain
- Describe the EDI transactions use in healthcare and IT stakeholders
- Understand the healthcare (Payer and Provider) data submission process
- Understand the importance of EDI exchange and data handling
- Understand and use the basic principles and rules of EDI transactions
- Understand and use basic loop and data segments with corresponding values
- Understand the HIPAA documentation
- EDI mapping functional and non-functional requirements
- Understand and gain hands on experience about the basic competencies required to work as a BA in the healthcare IT sector
- Learn how the healthcare market place or exchange work
- Learn about EDI data analyst role
- Be aware of employers need when applying for any EDI job
- Understand how to find best suited position of Healthcare Business Analyst
- 20+ Hrs of High Quality e-Learning Content
- Transaction covered – 834/837/276/277/275/278/835 etc
- Health Care (HIPAA) EDI Training Fundamentals
- Heatlhcare care Exchange (HIX)
- Heatlcare Market Place
- Self-Paced High quality e-Learning content
- 24/7 on demand Support
- Real time projects
Anyone having a general understanding of computer with good communication skills can opt for Business Analysis course. This course is suitable for:
- Students with a Bachelor or Master’s degree in any stream.
- Self-taught IT Business Analysts and Quality Assurance wanting to fill in the gaps and put all the pieces together
- Technical people who are interested in expanding their role into Healthcare IT.
- Executives and Managers want to get into Healthcare Industry
- People who want to start their career in IT / EDI
- Need to have Healthcare EDI domain knowledge to complete your job
- The course is also suited to anyone embarking on a career within IT or project management who requires an understanding of the Healthcare IT domain as Business Analyst role and the need for robust requirements.
- Introduction to Healthcare IT
- Branching Of Healthcare
- Framework of Healthcare Branches
- Healthcare Statistics
- Major developments in Healthcare
Office & Patient Management
- Information Exchange
- Medical Record
- Managing New Patients
- Managing Established Patients
- Clean Claim
3. CMS 1500
- When To Use
- How To Use
- Sample CMS 1500 Form
- Patient Information
4. Uniform billing
- When To Use
- How To Use
- Sample UB 04 Form
- Inpatient Information
- Outpatient Information
5. Coding overview
- CPT Coding
- Unlisted Codes
- HCPC National Level II Codes
- CPT Coding with Manual
6. Overview of ICD codes
- ICD History
- Why ICD codes?
- ICD Codes – What does it tell us?
- Use of ICD codes
- Anatomy and Terminology for Coders
- Advanced Anatomy and Terminology for Coders
- Coding for the Non-Coder
7. ICD 9 Vs ICD 10 History
- Why ICD-10 over ICD-9
- ICD-9 Vs. ICD-10
- ICD-10 CM Diagnosis Code – Overview
- ICD-10 PCS Procedure Code – Overview
8. ICD-10 codes
- Preparation Analyzer
- Anatomy and Terminology Essentials from an ICD-10-CM Perspective
- Anatomy and Terminology Essentials from an ICD-10-PCS Perspective
- General Equivalence Mappings (GEMs)
- ICD 10 Implementation phases
- ICD-10 Release Timeliness
- ICD-10 Impact to Payer
9. Overview Of Electronic Data Interchange
- History Of EDI
- EDI X12 Transaction Sets
- EDI HL7
10. What goes inside EDI TRANSACTIONS / MAPPING?
- 270 – Health Care Eligibility Benefit Inquiry and Response
- 271 – Health Care Eligibility Response
- 276 – Health Care Claim Status Request
- 277 – Health Care Claim Status Response
- 278 – Health Care Services Review – Request for Review and Response
- 837 – Health Care Claim Institutional, Dental, Professional
- 835 – Health Care Claim Payment / Advice
- 834 – Benefit Enrollment and Maintenance
- 820 – Payroll Deducted and Other Group Premium Payment for Insurance Products
11. Health Insurance Exchange?
- Introduction of HIX
- Introduction to HUB
- State Exchange Overview
- 1095 Tax Form and its usage
- 8962 Form & usage
12. Case Study
13. Resume & Interview Guideline
This course is designed for clearing interview for the Healthcare EDI positions. At the end of the course there will be a quiz and project assignments once you complete them you will be awarded with Elearningline Course Completion certificate.
The EDI course is nicely designed for all. I liked the study material. They are easy to understand and very well organised. I did not face any issue during my course with study material. Also my instructor Sushmita was a big help throughout. She is knowledgeable and has immense skill on EDI. Thanks E-Learning Line for this course.
I have taken EDI course with e-Learning Line. It was instructor led online course that I opted for and I must say my instructor was excellent. She has immense knowledge of the course and she has a huge help for me throughout the class. I am very lucky to be a part of e-Learning Line education. I would definitely like to take up other course under e-Learning Line.
Trainer brings a lot of excitement to her class and teaching, even for us who have no IT background. EDI class by trainer is a well thought through program. She poses distinct teaching skills and is ever ready to answer each and every question in her class. Her major concern has always been for students to grasp the principles and concepts of the course and topics rather than just answering her questions.
I am currently doing EDI Class from e-Learning Line. My Instructor is an expert in the relevant field. She teaches perfectly and keeps helping all of the candidates nicely. Especially the projects and case studies were very apt and related to real life. She shares a lot of her experiences with us so that we can apply them to the real time projects.
I am currently enrolled in the EDI Analyst. The instructor has been great from day one. She brings a lot of excitement to her class and teaching. She is having in depth knowledge of EDI and the best part of her is she has skills to transfer her knowledge to the entire batch.