Medical Provider Newsletter - November 2020

EDI claims submission requirement

EMI Health is pleased to offer the convenience, savings, and security of electronic claims submission. Claims submitted through EDI have a faster processing time than paper claims, and there is reduced chance of human error.

Participating providers are required to submit claims, other than those that include attachments, through EDI.

Using a clearinghouse

EMI Health uses the Utah Health Information Network (UHIN) as our clearinghouse. UHIN transmits standard electronic data transactions with all major clearinghouses through a secure, private gateway. If you are using a clearinghouse, the following information may be useful when submitting EDI claims to EMI Health:

  • Each clearinghouse assigns EMI Health a different payer ID, so you will need to obtain that number from your clearinghouse.
  • If you are searching for us by name, your clearinghouse may have us listed as EMI Health, EMIA, or Educators Mutual.
  • If your clearinghouse is not yet submitting your EDI claims to us, they will need to coordinate EDI enrollment on your behalf with UHIN. They may contact UHIN at www.uhin.org or 877-693-3071.
  • If you change clearinghouses, be sure to have the new clearinghouse notify UHIN of that change.

Direct through UHIN

You also have the option to submit EDI claims directly through UHIN. If you are not yet set up to submit claims through UHIN, you will need to obtain a trading partner number from them. You may contact UHIN at www.uhin.org or 877-693-3071. Once you've received your trading partner number, you may begin submitting EDI claims to our UHIN trading partner number, HT000214001.

Claims with attachments

Claims that include attachments may still be sent on standard paper claim forms, either through the postal service or through EMI Health's secure online claim upload. Each claim must be submitted individually. This feature is not for batched claims. You may also submit the claim through EDI and then upload the attachments through EMI Health's electronic attachments portal.

All other claims must be submitted through EDI. This will allow EMI Health to process your claims faster and more efficiently--benefitting your office, EMI Health, and most importantly your patients, our members.