This list reflects answers to frequently asked questions regarding Electronic Data Interchange (EDI).

The EDI Department supports:
• Clearinghouses or billing agents that submit ASC X12 transactions on behalf of providers through secure file transfer protocol (SFTP) or the NCTracks Provider Portal
• Providers submitting ASC X12 transactions directly to NCTracks, using either purchased or proprietary software, through secure file transfer protocol (SFTP) or the NCTracks Provider Portal
• Ramp Manager
• Pharmacy Point of Sale (POS) Vendors
• NCTracks Provider Portal (upload of ASC X12 batch files only)

The EDI Department does not support:
• NCID (see https://ncid.nc.gov/login/)
• NCTracks Provider Portal (unless regarding upload of ASC X12 file)
• Electronic Funds Transfer (EFT) and pre-note
• Claims processing/adjudication
• Pharmacy Point of Sale claims adjudication
• Taxonomy
• Assignment of PIN code
• TSN Assignment – NCTracks Provider Portal

For assistance with these non-EDI functions (except NCID), please contact the main Call Center number at 1-800-688-6696.

  • 1. What is EDI?

    EDI stands for Electronic Data Interchange. Essentially, it’s the exchange of data between sources electronically. In healthcare, the information exchanged includes, but it not limited to: claims, requests for eligibility information, claims payment information, etc. The sources exchanging the data (also known as transactions) are referred to as Trading Partners.

  • 2. What are the X12 ASC HIPAA transactions?

    Inbound Transaction (transaction TO NCTracks)
    • 837I – 837 Institutional
    • 837P – 837 Professional
    • 837D – 837 Dental
    • 270 – Eligibility Request
    • 276 – Claims Status Request
    • 834I – Benefit Enrollment and Maintenance
    Outbound Transaction (transaction FROM NCTracks)
    • 999 Acknowledgement Report
    • 271 - Eligibility Response
    • 277 – Claims Status Response
    • 277U – Claim Status Response, Unsolicited (generated at check write to report pending claims
    • 835 - Electronic Remittance or Explanation of Benefits