SimpliClaim: Software Solutions for Your Business

EDI claims for Workers’ Compensation require specific loops and segments to properly submit provider, patient, and injury details. Any missing or incorrect data can lead to claim rejections or delays.

Key EDI Loops & Segments for Workers’ Compensation

• Patient Demographics (Loop 2000A-2000C) – Ensures correct patient identification.

• Billing Provider Details (Loop 2010AA) – Verifies provider credentials and NPI.

• Claim Information (Loop 2300) – Includes injury details, diagnosis codes, and billing specifics.

• Payer Information (Loop 2330B) Ensures claim reaches the correct payer.

SimpliClaim can help by streamlining and automating the medical claims submission process, making it faster, more accurate, and less costly. 

SimpliClaim simplifies and accelerates medical claims processing by reducing errors, minimizing denials, and ensuring faster reimbursements and lower administrative costs for healthcare providers.

How SimpliClaim Helps

• Configures all necessary EDI loops & segments to meet NY WCB standards.
• Prevents claim rejections by ensuring accurate data entry.
• Provides expert guidance on Workers’ Compensation EDI formatting.

Switching to an automated EDI billing solution is the key to faster reimbursements, fewer rejections, and a more efficient workflow.

Manual vs. Automated Billing – What’s the Difference?

With SimpliClaim, providers can:

• Save time by eliminating manual data entry.
• Improve claim accuracy with built-in compliance checks.
• Get paid faster by reducing delays caused by errors or missing information