Electronic Data Interchange (EDI)

EDI Sign-Up

After reviewing the information below, please click on the appropriate link.

*Providers and Employer Groups PLEASE NOTE: You must select the link for California or the link for outside California, depending on your location, to access the on-line 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 1-717-260-7131.

Clearinghouse Trading Partner Agreement
Clearinghouse Trading Partner Application
EDI Reference Guide   (Revised January 2008)
Real-Time Connectivity Specifications

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 1-717-260-7131.

California - Provider Trading Partner Agreement
California - Provider Trading Partner Application
EDI Reference Guide   (Revised January 2008)
Real-Time Connectivity Specifications

Outside California - Provider Trading Partner Agreement
Outside California - Provider Trading Partner Application
EDI Reference Guide   (Revised January 2008)
Real-Time Connectivity Specifications