EDI claim edits now notify you of missing or mismatched information.
As of Aug. 28, 2021, the new payer-level edits for Electronic Data Interchange (EDI) 837 claim submissions provide alerts of specific information that may be missing or doesn’t match data contained in our systems.
How will you be notified of claim issues?
Claims that are rejected for these edits will appear on your claims rejection report, also known as a 277CA report. UHC is no longer mailing letters about claim submissions that need attention. Instead, your clearinghouse will be responsible for notifying you of any issues.
What do you need to do?
Ensure you are receiving these messages from your clearinghouse. Claims that are rejected should be corrected and resubmitted electronically to be accepted into our processing system for adjudication.