The EDI Service will receive and deliver transaction data (claims, claim status, remittances, etc.) between AvMed Health Plans and its Trading Partners. To AvMed a Trading Partner is any external organization, physician or hospital that transacts business in our electronic environment.

Resources:

CAQH/CORE
CMS
WPC
AvMed remit codes explanations
AvMed Claim status codes used

5010 Transactions

AvMed's real-time based eligibility, benefits and claim status application follows the standard operating rules defined by Phase I and Phase II of the CAQH/CORE requirements. For further information on how to use the new application, please see the 270/271 and 276/277 Companion Guides

Transaction  Description  Companion Guide
Transaction 270/271Description Eligibility Request and ResponseCompanion GuideGuide
Transaction 276/277Description Claim status Request and ResponseCompanion GuideGuide

 NOTE: To see the other 5010 transactions available see Contact Us.

 

Regular Scheduled Maintenance

The real-time transactions may not be available due to regular system maintenance during the following times:

  • Every Sunday 8:00 PM - 9:00 PM (Eastern Time)

Unscheduled Maintenance or Emergency Downtime

  • None at this time