Spotlight: Electronic Data Interchange Health Care Claims (November 2023) 

Electronic Data Interchange (EDI) is the exchange of standardized electronic documents between organizations. EDI creates efficiencies in provider workflows and automates the processing of health care claims. Payers with annual premium volume exceeding $1 million are required by COMAR 10.25.09, Requirements for Payers to Designate Electronic Health Networks to report census level information on health care transactions to MHCC. This brief provides an overview of EDI in health care and the impact of electronic claims submissions.

Electronic Data Interchange in Health Care: Examining Impact and Reasons for Paper Claims Activity (October 2021) 

Electronic Data Interchange (EDI) is the exchange of standardized electronic documents between organizations. EDI creates efficiencies in provider workflows and automates the processing of health care claims. Payers with annual premium volume exceeding $1 million are required by COMAR 10.25.09, Requirements for Payers to Designate Electronic Health Networks to report census level information on health care transactions to MHCC. This brief provides an overview of how electronic data interchange (EDI) has impacted the health care industry and leading reasons why a small percentage of claims are submitted on paper.