HIPAAsuite IT Software Medical Claims Audit HIPAA Hipaa Suite Medical Claims Audit and Software
HIPAAsuite medical claims audit HIPAA Compliant Medical Claims Audit


 

HIPAA Auth and Review Pro

HIPAA IT Software for the 278 transactionset

What is the HIPAA Auth and Review Pro?

The HIPAA 278 Auth and Review Pro is HIPAAsuite's module for the X12 278 Transaction Set (Requests for Authorization and Services Review). The request information coming from a provider is parsed from the EDI file and displayed in a screen. After review an X12 278 Response to an Authorization and Services Review Request can be created and send back to the requester. The request information with the response is also stored in HIPAAsuite's database and can be recalled.

Download the detailed help documentation for HIPAA Auth and Review Pro. - Acrobat PDF

By implementing the HIPAA 278 Auth and Review Pro, you will increase productivity through the following features:

  1. Ability to receive and process 278 Requests for Authorization and Services Review and to be able to create X12 278 Response to an Authorization and Services Review Request
  2. Build-in translation engine extracts the information in an X12 278 Requests for Authorization and Services Review and stores that information in a database.
  3. Requests that are displayed in a screen like the one displayed below:


    Medical Claims Audit Software and Products
    Fig1 Displaying a X12 278 Requests for Authorization and Services Review (Click to enlarge)

  4. Ability to view the very detailed and specialized information that can be in a 278 Request:

    HIPAA Auth and Review Pro
    Fig2 shows Home Oxygen Authorization Request as an example to the additional services that can be contained in a 278. (Click to enlarge)

  5. Ceate a response that either is a rejection, a denial or an authorization

    HIPAA Compliant Authorization Software
    Fig. 3 Creating the response to an Authorization and Services Review Request (Click to enlarge)

  6. EDI viewer that allows you to view the content of the EDI file color coded and with each segment on a new line, which is helpful in viewing raw EDI data segments to debug or fine tune the processing of EDI.

    Healthcare Audit Pro and claims

    Fig. 4 The 278 Response to an Authorization and Services Review Request that was created with the HIPAA Auth and Review Pro. (Click to enlarge)

 


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HIPAA IT Medical Claims Audit Disclaimer - HIPAA requires healthcare organizations to implement security measures to ensure the confidentiality of client healthcare including information about medical claims, auditing and billing. Do you have concerns about how your healthcare organization can remain in compliance with HIPAA regulations? Contact our HIPAA suite administrator for questions regarding our HIPAA software products and medical claiming auditing.