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Clearinghouse/Direct Connections for Electronic Data Exchange

Group Health Cooperative utilizes business-to-business electronic data interchange (EDI) to facilitate our claims processing, patient billing, and care management systems.

EDI exchanges include both ASC X12 formatted transactions and some non-X12 data exchanges. The X12 formatted transactions may be exchanged using a direct connection with Group Health or an affiliated clearinghouse. (PDF)

A direct connection is available if you can answer Yes to all three of these questions:

  • Are you submitting more than 250 electronic claims per month?
  • Do you have the ability to process HIPAA-compliant X12 electronic transactions?
  • Can you submit secure file transfers (secure channel or encryption such as PGP or Gnu PG)?

EDI Exchanges Available

Trans-
action ID
Process Mode Protocol Envelope
270/271 Batch/ RealTime FTP/ HTTPS SOAP/ MIME Companion Guide (270/271) (PDF)
276/277 Batch/ RealTime FTP/ HTTPS SOAP/ MIME Companion Guide (276/277) (PDF)
834 Batch FTP N/A
835
(EFT/ERA)
Batch See InstaMed N/A InstaMed
837 Batch FTP N/A
NCPDP RealTime T1/VPN N/A

To initiate or update an EDI exchange, submit a completed EDI Trading Partner Setup Request Form (Word).

Questions about our EDI exchanges may be e-mailed to edisupport@ghc.org or contact the Provider Assistance Unit toll-free at 1-888-767-4670.

Revised 12/3/2013

The Provider Manual is not intended for any use by any party other than as a resource for Group Health Cooperative's contracted providers in fulfilling their obligations under provider contracts. Group Health intends for the manual to be accurate for its intended purpose but doesn’t guarantee accuracy. Providers should comply with the terms of their provider contracts and any legal requirements in the event of an inconsistency between the manual and a requirement in their provider contracts or the law.

Copyright 2014 Group Health Cooperative