The HIPAA Eligibility Responder parses the information that is contained in an X12 270 EDI Eligibility Request file and allows you to enter the appropriate information manually. It then packages the benefit eligibility information into a X12 271 EDI Eligibility Response file.
This software is designed to give HIPAA compliance in regard to the 270/271 transaction sets without a big investment and is aimed at organizations that do not expect a large volume of electronic eligibility requests but want to be in compliance with federal regulations.
Download a 15-day trial version of the HIPAA Eligibility Responder.
Download the detailed help documentation for HIPAA Eligibility Responder.  - Acrobat PDF
Watch a Demo
The HIPAA Eligibility Responder will enable you to:
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Display the eligibility request information on screen.
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EDI code sets are translated into their descriptions to show the transactions clearly and understandably.
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Choose from drop down menus the appropriate code sets and avoid data entry mistakes.
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Return a simple answer, the HIPAA minimum requirement or add the complete spectrum of information that the 277 transaction set allows
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Package multiple eligibility responses into one file
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Set a default status response that gets filled in, if you don't create a specific answer, like "Claim not Found" or "No further information available"
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Edit the code sets, so you will have to choose only from a subset of the hundreds of codes that HIPAA provides.
Here some screen shots:
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Fig1 shows the HIPAA Claim Status Responder with three requests listed . (Click to enlarge) |
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Each individual request can then be called up and answered. The status information and any other codes can be selected from a drop down box, so there is no possibility to enter wrong codes. THe picture below shows a claim status request that has only claim level information. The status information has been filled in. |
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Fig2: Answering an individual request .(Click to enlarge) |
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