We use existing HIPAA EDI transactions: X12 EDI 274, 276, 277, 835, and 837. The preferred version is X12-5010 but older 4010 transactions are supported on a case-by-case basis.

Yes, we process existing EDI files. Additionally, we can create 276 and 274 request files from existing data.

EDI files are uploaded through our Secure Web site.

Yes, we can process EDI files into spreadsheet formats (csv) as well as custom file formats (i.e. XML, JSON).

We can have the reports up and running in as little as two weeks once the initial batch of Medi-Cal and/or Medicare EDI files have been uploaded to the Web Portal.

No, files can be uploaded in any order. Duplicate data is fully handled by the system and is ignored if the data has already been processed.

Very secure. In addition to adhering to FIPS standards, 2-factor authentication (2FA) is required to access the web site. Individual User Roles are created granting specific access to each user role.

Yes, access can be controlled to show differing levels of PHI to different access groups.

No, a web browser (such as Chrome or Firefox) and spreadsheet software (such as Excel or Sheets) are all that are needed.

All PHI data is stored with high level encryption at rest, meaning data it is encrypted while being stored on disk.

Reports can be processed hourly, daily, weekly, bi-weekly and monthly, all depending on customer needs.

We currently have business rules for Drug-Medi-Cal, Mental-Health-Medi-Cal, Drug-Medicare, and Mental-Health-Medicare, as well as rules for private health care organizations.

Yes, we have business rule engines that reconcile submitted claims with payment information.

We work with State Counties, Health Care Plans and Health Care Providers.

We use the Software-as-a-Service (SAAS) model, and we can support monthly or yearly subscriptions.

We provide around-the-clock support for any technical and/or business questions by our highly trained staff of individuals.

Contact us for a free review of your needs