The HIPAA Claim Master

837 EDI Claim transactions made easy

The HIPAA Claim Master is an advanced software application for electronic healthcare claims. It gives you complete control over every aspect of EDI claims.

Overview of the Features:

A built-in EDI translator that parses the information from the electronic claim files.
Standard claim forms are rendered electronically. No pre-printed forms are needed. The forms are exact facsimiles of the standard forms and align precisely with the originals.
Data from the electronic claims is then displayed in those forms.
Additional forms that display information that does not fit on the standard forms such as COB adjudication data or medical specialty information is displayed on additional pages with translated code sets.
Four output modes:
- Screen
- Printer
- Image file (TIFF or PDF)
- Export data to external database
Database tables contain nearly every field within the EDI file, searchable and ready for your applications.
Handles 837 I, 837 P, 837 D and 837 R
Create 837 EDI files from database records
Enter and edit claims in the database
Automate processing in combination with the Windows scheduler
Compliance check, encryptions and trading partner management with optional EDI Exchange module

Electronic Claim Imaging

Each claim can be rendered as either UB04, CMS-1500 and ADA 2006 or the older UB92, HCFA-1500 or ADA2000 standard claim forms. These images can be viewed on screen, printed or turned into image files (PDF and TIFF). PDF Images are searchable. Image files can be added and imported to an image management system. Special pages are created to display content that has no representation on the forms.

Export Electronic Claims to any Database

The HIPAA Claim Master can export each claim to practically any ODBC aware database such as Microsoft SQL Server, Oracle or MySQL or even Microsoft Access. The claim data is then accessible to your applications. The claim image can be recreated from the database.

Create 837 EDI files from Database Records

Claim records in the database can be exported as 837 EDI files. You can populate the claim tables through your own processes and our software creates the EDI files. And in conjunction with EDI Exchange any outgoing records are checked for HIPAA compliance and those that don't conform can be removed.

Manual Claim Entry and Claim Editing

New claims can be added manually to the database with our HIPAA Claim Entry module. Once they are stored in the database, one can create HIPAA compliant claim files from those manually entered claims. Any claim that is in the database can be edited in contextual screens with all codes translated.

The HIPAA Claim Master works with both the 4010 and 5010 EDI version format and even allows to translate 4010 claims into 5010 claims and vice versa.

The HIPAA Claim Master will improve the way you process your healthcare claims in many different ways, including:

Ability to process HIPAA compliant claim files without a huge investment in a new claim system or the re-engineering of processes and software.
Workflow systems and image libraries that rely on scanned claim images can now use the HIPAA Claim Master to produce those images from EDI files
Integration into image store system with image index database or an ASCII file that contains pertinent image and claim data for retrieval
Ability to process files through a command line call arguments. Can be used with Windows scheduler for process automation.
Flexibility to use as a testing tool to visually inspect the results of an EDI conversion.
Convenience of using forms that are created in software code and therefore don't have to be pre-printed.
Processing of individual claim files as well as batches of many. The output form is determined by the claim type.
Different options to set the resolution of the output file from 600 x 600 dpi down to 50 x 50 dpi. You can choose color, grey scale or black and white mode for the image file.
Ability to save the claim as an individual image file with its own generated filename to allow easy retrieval for CSR or workflow systems
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 to debug or fine tune the processing of EDI.
Export of claim data from EDI files into legacy systems.

Current customer's testimonial to the benefits that the HIPAA Claims Printer has brought to their business.

"HIPAA Claim Master allowed us to integrate EDI into our workflow system while maintaining the familiar claim formats to our claims adjusters and other staff. This made viewing and printing 837's painless, non-disruptive and cost effective. HIPAA Claim Master is a great tool that we can recommend unequivocally."
Don Stoller, Senior Vice President IT --- Screen Actors Guild - Producers Pension and Health Plan, Burbank, CA

"Claimviewer has provided us with the ability to print EDI 837 transactions to paper or as .tif files, which we use for both verification and as a backup solution. We've also utilized Claimviewer as a contingency plan in meeting Governmental compliance deadlines for EDI. The flexibility and ease of use is impressive."
TRAS, LLC (t/a Three Rivers Health Plan, Pittsburgh, PA)

"We are developing an imaging and workflow solution for a health insurer's HIPAA implementation. They required that we be able to display and print electronic 837 transactions as though they were familiar claim forms. This looked like a huge job. But HIPAAsuite's HIPAA Claim Master turned out to be easy to integrate, saved us countless development hours, and thus saved our customer's budget. HIPAAsuite has been easy to work with and extremely responsive to our requested design enhancements."

Charley Cross, eiStream WMS, www.eiStream.com