The HIPAA Premium Payment Master

Software for the HIPAA 820 Transaction Set

The 820 transaction set contains premium and policy payment information. This is another part of the HIPAA stipulted EDI transactions.

Target for this transaction is the interaction between a sponsor, i.e. an entity that pays for someone's health care, and an entity that administers or delivers health care services. For example a large employer that has a contract with an Insurance company or a TPA (Third Party Administrator) pays its employees' health insurance premiums. The information can either be very detailed and contain some demographic information on each individual that is covered or just a summary of the payment.

The HIPAA Premium Payment Master processes the information contained in those 820 EDI files. It displays the data in forms on screen, saves this image to a PDF or TIFF file or prints it to paper. The cryptic EDI information is translated and each element in the EDI file is properly displayed. A perfect solution for those with small volumes of 820 files who can use manual entry into their accounting system.

With its database module enabled the HIPAA Premium Payment Master can export the EDI data to any ODBC compliant database, such as Microsoft SQL Server, Oracle or most other databases. Each individual record and element in the EDI file is saved in our staging tables. Ideal for those with larger volumes of 820 EDI files and who will create their own processes from the exported data in our staging tables. The reverse process from SQL to EDI is in the planning stage. Please inquire for more information.

The HIPAA Premium Payment Master can:

Process Premium Payment information that was submitted in an X12 820 transactions.
Display the information for each payment on a form that can be printed.
Export 820 data to two staging tables in any ODBC compliant database, such as SQL Server, MySQL and Oracle
Integrate with an existing system through the database interface
Automate processing through the scheduler and command line arguments

View the detailed documentation