Electronic Data Interchange (EDI)

EDI Sign-Up
After reviewing the information below, please click on the appropriate link. To find out more about Electronic Data Interchange, please read The Benefits of Electronic Data Interchange page.

*Providers PLEASE NOTE: You must select the link for California or the link for outside California, depending on your location, to access the online forms for the required applications.

Clearinghouse/Practice Management Software Vendor
To request authorization to send EDI transactions (Claims and Inquiries, ASC X12 transactions: 837, 835, 276/277, 270/271) to United Concordia or to update your existing Trading Partner record, click the links below. Print and complete the forms and fax to Dental Electronic Services at 1-717-260-7131.

Clearinghouse Trading Partner Agreement

Clearinghouse Trading Partner Application

EDI Reference Guide (Revised May 2008)

Provider
PLEASE NOTE: Your Practice Management Software must have the ability to directly communicate with United Concordia.

To request authorization to send EDI Transactions (Claims and Inquiries, ASC X12 transactions: 837, 835, 276/277, 270/271) directly to United Concordia or to update your existing Trading Partner record, click on the appropriate link below. Print and complete the forms and fax to Dental Electronic Services at 1-717-260-7131.

California - Provider Trading Partner Agreement

California - Provider Trading Partner Application

EDI Reference Guide (Revised May 2008)

Outside California - Provider Trading Partner Agreement

Outside California - Provider Trading Partner Application

EDI Reference Guide (Revised May 2008)