Electronic claim

Insurance claim submitted to the insurance carrier by a provider of medical services or electronic media claim (EMC) vendor transmitted via a central processing unit (CPU), tape, diskette, direct data entry, direct wire, dial-in telephone, digital fax, or personal computer download or upload.

electronic data interchange (EDI)

Process by which understandable data items are sent back and forth via computer linkages between two or more entities that function alternatively as sender and receiver. Common examples for medical billing that use the X12 format are insurance claims, quality assurance reviews, utilization data, and certifications. See also Accredited Standards Committee X12 (ASC X12) .