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Electronic Data Interchange (EDI) Transactions

Electronic claim submission increases accuracy because claim information received is loaded directly into our system. We can also receive coordination of benefits (COB) claims and corrected bills electronically.

The language used in electronic transactions is called X12 and is subject to national standards. We support a variety of EDI transactions (see below) and require all external trading partners to submit these transactions through the Utah Health Information Network (UHIN).


Payer ID Information

Select Health does not have a single payer ID; however, you can access a Payer ID List that aligns common software/clearinghouse information with the payer ID each uses for Select Health. This list is updated monthly. If the clearinghouse has a search function, we can be found under the name “Select Health,” or possibly under one our former names, “Intermountain Health” or “IHC Health Plans.” Download the Latest Payer ID List.


Questions?

Contact our EDI team at:

Use the 837 transaction to submit claims electronically, which allows for faster adjudication and payment. The 837 generates responses that tell you if claims were accepted or rejected and, if necessary, the reason for the rejection. The two responses generated are:

  • The Functional Acknowledgement (999) ‒ This transaction contains details about submissions, including the accepted/rejected status and reason(s) for rejections. A rejection will not progress and must be corrected and resubmitted for consideration. If you receive a status that indicates there was an error in your file and are unsure to which claim an error applies, please contact us.
  • The Healthcare Claims Acknowledgement (277CA) ‒ For all claims accepted in the 999, this transaction provides information regarding the accept/reject status of claims based on our internal requirements. If a claim rejects on the Healthcare Claim Acknowledgment, it requires correction of the inaccurate data and resubmission to be considered. You may receive more than one rejection for a claim.

Within this transaction, reported claims are assigned a category code, status code, and entity code as follows:

Category Code
Status Code
Identity ID Code
Description
A2
19
40
Claim accepted in our adjudication system for pr
A3
153
HK
Claim Rejected: Subscriber Not Found (Missing or
A3
158
03
Claim Rejected: Dependent Not Found (Missing or
A3
125
03
Claim Rejected: Dependent Not Found (Missing or
A3
54
40
Claim Rejected: Duplicate Claim
A3
562
40
Claim Rejected: Missing or Invalid NPI Number
A3
88
QC
Claim Rejected: Patient Not Eligible
A3
255
Claim Rejected: Diagnosis Code

This transaction helps verify a member's eligibility and benefit information without having to contact Member Services. The 271 response contains information on eligibility, eligibility dates, copays, coinsurance, deductibles, out-of-pocket maximums, visit limits, and benefit limits.

If a 270 is submitted as a real-time transaction, the 271 response will be received within 20 seconds.

For more information, download the Centers for Medicare and Medicaid Services (CMS) 270/271 Health Care Eligibility Benefit Inquiry and Response Companion Guide for Mandatory Reporting Non-GHP Entities.

This transaction helps verify the status of a specific claim. The 277 response includes the:

  • Current status (i.e., received, pended, or finalized) and status dates
  • Paid amounts and payment information once finalized

If a 276 is submitted as a real-time transaction, the 277 response will be received within 20 seconds. For more information, download the CMS Standard Companion Guide Health Care Claim Status Request and Response (276/277).

Note: In Q1 2026, Select Health will manage all provider payments through Zelis. If you have not done so, please enroll in Zelis using the information below to ensure that the payment type you need will continue through the transition. If you need more information about your options, please reach out to Zelis.

ACH+ or VCC options (fee-based):

  • Phone: (877) 828-8770

Standard EFT/ERA Transactions (no-fee EFT):

What is the ERA, 835, and EFT? 
  • Electronic Remittance Advice (ERA or 835) details payment information on claims. The ERA, available through Electronic Data Transmission Interchange (EDI) transaction 835, is more efficient than waiting for a paper remittance advice. Most software systems can use an 835 to automatically post payments to the proper accounts.
  • Electronic Funds Transfer (EFT) deposits funds for SelectHealth claim payments directly into your bank account. To receive the EFT, you must also be able to accept the 835.

If you are switching to a new bank, your remittance will be dropped to paper check. For security reasons, Select Health/Zelis need to pay via paper checks for two weeks (four pay periods) before we can add a requesting provider to the new bank.

You can receive an ERA (835) with payment through electronic funds transfer (EFT) or you can still receive a paper check by completing and submitting one of two online forms. If you want to receive:

Note: These forms will be discontinued once Zelis comes online in Q1 2026. If you are not enrolled with Zelis, please consider enrolling now to avoid any delays. 

  • The 835 but would prefer to continue to receive your payments as paper checks, complete the 835 form.
  • The 835 and EFT payments, complete the EFT form.

Upon request, we will send a paper remittance advice as well as an 835 for the first 31 days so that you can receive remittances appropriately. You may need to contact your clearinghouse to make sure they send responses to you. Once that transition period has lapsed, the remittance advice will only be sent electronically; no paper remittances will be sent.

I need to set up my clearinghouse delivery with Zelis. 

Each week, remittance advices and payments are sent as follows (subject to change):

  • Medical 835: Monday, Thursday
  • Dental 835: Wednesday
  • Medical EFT: Tuesday, Friday
  • Dental EFT: Thursday 
  • Medical Paper Remits: Wednesday, Friday
  • Medical Paper Checks: Wednesday, Friday
  • Dental Paper Remits: Tuesday
  • Dental Paper Checks: Tuesday

If you have late or missing EFT or ERA (835) Resolutions, contact your software vendor or clearinghouse to make sure they know to send the information to you. If you have not enrolled directly through them, they may receive the ERAs but not have known where to forward them or whom to notify.

If you are missing either an EFT payment or an 835 remittance advice, email our EDI Team, or call 800-538-5099.