EDI Claim Submission Requirements
There are several formats that are accepted by Emdeon for EDI claim submission.
Emdeon Submission Requirements
Use the appropriate Emdeon Requirements document(s) listed below to format your EDI claims for electronic submission to Affinity Health Plan.
Emdeon 837 Provider Companion Guide
Emdeon NSF + Requirements
Emdeon HCDS + Requirements
Affinity Health Plan Submission Requirements
In addition to the requirements listed in the Emdeon Companion Guide, the following information, unique to Affinity Health Plan claims, must be provided and properly formatted in the EDI file.
837 Professional (837P)
837 Institutionsal (837I)
Other than the 4010A1, the formats listed below (NSF+ and HCDS+) are the only other formats for submitting claims with NPIs to the Emdeon clearinghouse. Affinity Health Plan urges providers to use the 4010A1 format for their electronic claims submissions.
NSF + (National Standard Format)
HCDS + (Institutional)