HealthCare HIPAA EDI Solutions
For Health Information Exchange HIE
SoftCare’s
HIPAA EDI (Electronic Data Interchange), Data
Communications and Application Integration software
solutions provide standards based solutions whose goals
are to reduce costs of EDI
implementation, integration and improve timeliness
and quality of information exchange
with your EDI and EHR Trading Partners.
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SoftCare's business process consultants,
designers, integration experts bring innovative Best
Practices approaches to Healthcare
Electronic Data Interchange (EDI) and Electronic Health
Record (EHR) interoperability.
Our experts will bring your HealthCare Organization,
Provider Organization, Third Party Administration
Business or HealthCare Insurance Carrier Payer into full
compliance in a structured cost effective and timely
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HealthCare Business Chain Solutions
For Provider Groups, Third Party
Administrators & Payers
Standards Based HealthCare Provider Interoperability Solutions for Provider Groups, TPA, IPA, PPO, Payers and (Provide -Patient) information exchange and application integration. read more
HIPAA EDI Solutions
Analysis, EDI Software Solution, Integration Services
EDI 837 - EDI Health Care Claim Transaction set (837) is used to submit health care claim billing information, encounter information, or both. It can be sent from providers of health care services to payers, either directly or via intermediary billers and claims clearinghouses
EDI 835 - EDI Health Care Claim Payment/Advice Transaction Set - ERA can be used to make a payment, send an Explanation of Benefits (EOB) remittance advice, or make a payment and send an EOB remittance advice only from a health insurer to a health care provider either directly or via a financial institution
EDI 834 - EDI Benefit Enrolment and Maintenance Set can be used by employers, unions, government agencies, associations or insurance agencies to enrol members to a payer. The payer is a healthcare organization that pays claims, administers insurance or benefit or product.
EDI 820 - Payroll Deducted & Group Premium Payment for Insurance Products (820) this transaction set can be used to make a premium payment for insurance products. It can be used to order a financial institution to make a payment to a payee.
EDI 824 - Application Advice transaction set can be used to report the results of an application system's data content edits of transaction sets. The results of editing transaction sets can be reported at the functional group and transaction set level in either coded or free-form format. It is designed to accommodate the business need of reporting the acceptance/rejection or acceptance with change of any transaction set.
EDI 997 & EDI 999 are Functional Acknowledgement Transaction Sets that are automatically managed by the SoftCare TradeLink software solutions.
HIPAA EDI Solutions
Analysis, EDI Software Solution, Integration Services
EDI 270 - EDI Health Care Eligibility/Benefit Inquiry is used to inquire about the health care benefits and eligibility associated with a subscriber or dependant under the subscriber's policy. A subscriber is a person who elects the benefits and is affiliated with the employer or the insurer
EDI 271 - EDI Health Care Eligibility/Benefit Response is used to respond to a request inquire about the health care benefits and eligibility associated with a subscriber or dependant.
EDI 276 - EDI Health Care Claim Status Request this transaction set can be used by a provider, recipient of health care products or services or their authorized agent to request the status of a health care claim. This document and the Health Care Claim Status Notification (277) are envisioned to be the next documents to be implemented by larger Health Care organizations
EDI 277 - Health Care Claim Status Notification transaction set can be used by a health care payer or authorized agent to notify a provider, recipient or authorized agent regarding the status of a health care claim or encounter, or to request additional information from the provider regarding a health care claim or encounter.
EDI 278 - Health Care Service Review Information transaction set can be used to transmit health care service information, such as subscriber, patient, demographic, diagnosis or treatment data for the purpose of request for review, certification, notification or reporting the outcome of a health care services review.
Health
IT and EDI Software Solutions Interoperability Solutions
for Providers,
(3rd Party Administrators,
IPOs, PPO
and Payers
information exchange and
application integration.
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Professional
Services SoftCare's depth in Consulting
and Integration Services for Strategy,
System Design and Integration of Health
Information Exchange
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