EDI Managed Services

Our business model is simple and straightforward. We will support all of your current and future EDI Gateway services including:

  • Implementation and management of all core EDI administrative transactions, including paper claims management, claim attachment management, superior claim editing, trading partner reporting and strong service and through-put level guarantees
  • Migration and, management and servicing of existing network and trading partners
  • Implementation of non-core EDI transactions such as enrollments
  • Integration and translation services for proprietary text and binary files
  • Implementation and management of current and emerging clinical transactions

Clinical Data and Analytic Services

As clinical data standards emerge, we are at the forefront of putting this data to work for you through translation, routing and partnering with innovative analytics companies.

  • Translation of clinical data to proprietary plan formats
  • Routing of clinical data to human readable repositories
  • Partnering with analytics companies or integrating with plan analytics vendors to support decision making

Integration Services

Our robust toolset is able to handle any of your data streaming requirements. Streaming data is any data that enters or exits your core business processing database. We can manage and process non-standard EDI, proprietary text and binary files and link individual transactions into related workflows.

  • Tolerance-based data routing
  • Proprietary text, HL7 and non-standard EDI translation
  • Transaction work flow reporting
  • Streaming data surveillance

Portal and Development Services

  • Payer, EMR and administrative transactions
  • Provider engagement portal development, ongoing innovation and management
  • Progressive WEB (PWA) application development
  • Event registration and session / attendance tracking-RFID based services

Provider Portal & EDI Managed Services

  • Payer based provider portal and EDI gateway strategic outsourcing
  • All HIPAA EDI administrative transactions
  • Existing network and trading partner management; non-administrative EDI and HL7 transactions
  • Membership enrollment and payment reconcilliation
  • Proprietary text and binary transaction management and conversion
  • Emerging clinical transactions and clinical data exchange
  • Strategic data surveillance and monitoring
  • Templatized, actionable and adaptable network, provider and application reporting

Strategic Professional Services

  • clinical data and analytics
  • health plan portal and EDI consulting and strategic planning
  • Medicare secondary billing changes / strategy / implementation