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EDI - On The Cutting Edge
Rich Winter & Susan Kvammen
EDI Managers

 Rich Winter - EDI ManagerSusan Kvammen, EDI Manager

The Ortivus North America (NA) EDI – acronym for Electronic Data Interchange - department is in constant contact with all carriers that it supports. If a carrier is requiring modifications to data or new/modified edits, most of the time, the carrier will notify Ortivus NA EDI about these changes. Other times, customers send in notifications of upcoming changes. Customer involvement in these matters is greatly appreciated.

Following any type of notification, Ortivus NA EDI verifies these changes with the carrier. The process of the instruction set modifications is a step-by-step process and sometimes, hard to predict how long it will take to complete the changes.

When Ortivus NA EDI contacts the carrier, the answers are not always provided on the first call; this step sometimes takes up to a week. When all the questions are answered, the next step is implementation into the instruction set, which can vary in timeframe depending on the complexity of the changes. If the changes made to the instruction set are mandated to be implemented in a short time period, Ortivus NA EDI notifies its customers who are affected by these via email. Customers are also encouraged to utilize the Ortivus NA Website Customer Support section to monitor state specific instruction set modifications (see “Sweet Hot Topics” for more information).
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The Ortivus NA EDI Department also conducts testing for new insurance carriers, as requested by our customers. Helpful information includes carrier Website addresses and EDI contact names. Ortivus NA EDI will require the customer to submit test claims with the respective carrier until Ortivus NA is an approved vendor.

Ortivus NA understands the importance of customer incoming revenue from claim submission and strives to stay up-to-date of all carrier requirements by following carrier’s speculations.