What is the role of electronic data interchange in claims submission?

• A. It transmits electronic claims over the Internet from provider to health insurance company.
• B. It analyzes claims for coding errors automatically.
• C. It routes claims to the patient via email.
• D. It creates patient medical records.

Answer: (A)

Electronic data interchange in claims submission is the standardized electronic transmission of claim data from a provider to a payer. It moves the claim information securely over a network to the health insurance company, avoiding paper and manual entry, and uses uniform formats so the payer can read and process it efficiently. This standardization reduces errors and speeds up adjudication, since the data fields and codes are consistent across systems. Other options don’t fit because automated coding checks are done by claim-editing software or payer systems, routing claims to patients by email isn’t how claims are delivered, and creating patient medical records is handled by the EHR rather than the claim submission process.