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Electronic Data Interchange (EDI)

EDI Sign-Up

After reviewing the information below, please click on the appropriate link. To find out more about Electronic Data Interchange, please read The Benefits of Electronic Data Interchange page.

*Providers PLEASE NOTE: You must select the link for California or the link for outside California, depending on your location, to access the online forms for the required applications.

Clearinghouse/Practice Management Software Vendor

To request authorization to send EDI transactions (Claims and Inquiries, ASC X12 transactions: 837, 835, 276/277, 270/271) to United Concordia or to update your existing Trading Partner record, click the links below. Print and complete the forms and fax to Dental Electronic Services at (717) 260-7131.

Clearinghouse Trading Partner Agreement

Clearinghouse Trading Partner Application

EDI Reference Guide (Revised May 2008)

Provider

PLEASE NOTE: Your Practice Management Software must have the ability to directly communicate with United Concordia.

To request authorization to send EDI Transactions (Claims and Inquiries, ASC X12 transactions: 837, 835, 276/277, 270/271) directly to United Concordia or to update your existing Trading Partner record, click on the appropriate link below. Print and complete the forms and fax to Dental Electronic Services at (717) 260-7131.

California - Provider Trading Partner Agreement

California - Provider Trading Partner Application

EDI Reference Guide (Revised May 2008)

 

Outside California ;- Provider Trading Partner Agreement

Outside California - Provider Trading Partner Application

EDI Reference Guide (Revised May 2008)

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