Electronic Data Interchange (EDI)

What is EDI?

Electronic data interchange (EDI) is a powerful tool for increasing office productivity and improving cash flow. The benefits of the EDI services offered by AmeriHealth New Jersey include:

  • Faster processing and timely error reporting for claims
  • Automated posting of claim payments
  • Real-time verification of a patient’s coverage and cost-sharing responsibility

Getting Started with EDI

Highmark, Inc. (Highmark) provides the Highmark Gateway to handle EDI transactions on behalf of AmeriHealth New Jersey. You may conduct EDI transactions directly with the Highmark Gateway by registering as a new trading partner. Alternatively, you may contract with a third party that has an existing trading partner relationship with Highmark, such as a billing service or clearinghouse.

To start conducting EDI business with AmeriHealth New Jersey, please take the following steps:

  • Get your NPI and register it with AmeriHealth New Jersey.
  • Select a trading partner or sign up as your own trading partner.
  • Affiliate your NPI with your trading partner to enable electronic transactions.

The Trading Partner Business Center is our online resource that provides tools and documentation for conducting EDI business. Visit the Trading Partner Business Center to enable electronic transactions for your NPI or to sign up as your own trading partner.

Additional Resources

For the latest provider news, including information about our System and Process Changes, visit our Provider News Center.

For questions related to conducting EDI business with AmeriHealth New Jersey via the Highmark Gateway, please call Highmark EDI Operations at 1-800-992-0246. Highmark EDI Operations is available Monday through Friday, 8 a.m. to 5 p.m., ET.