Electronic Data Interchange
Ohio Health Choice prefers to send and receive claims electronically, and is able to implement an EDI connection with any payor who also desires to use EDI for claims transmission. Below are useful resources regarding EDI claims exchange with Ohio Health Choice. Payors may contact Lisa Viront at 800-554-0027 or virontl@ohiohealthchoice.com to start the EDI implementation process.
| Name | Description | |
|---|---|---|
| Direct EDI Implementation Guide | Use this if the payor will receive the claims first and forward appropriate claims to Ohio Health Choice for repricing. Ohio Health Choice will then return the repriced claims to the payor. | Download |
| Outbound Only EDI Implementation Guide | Use this if Ohio Health Choice will receive the claims first directly from the providers, then forward repriced claims to the payor. | Download |
| Ohio Health Choice Repricing Reasons | This is a listing of the repricing reason codes used by Ohio Health Choice, along with additional information that may be helpful when processing repricing claims. | Download |