HIPAA CLAIM PAYMENT MASTER

After electronic claims were introduced in 2003, the most important transaction became the Electronic Claim Payment Advice. It replaced paper EOB’s (Explanation of Benefits) and handles the most complex claim payment adjustments. The industry knows how hard it can be to deal with these type of transactions, but It’s acceptance is now wide spread creating a need to handle the following:

• Display EDI 835 claim payment advice files in a readable format
• Export the payment information to a database
• Recombine claim and claim payments
• Translate paper checks into 835 electronic payment advice files
• Adjudicate claims
• Create 835 EDI files
• Pay claims via ACH
• Tie in claim status responses (277)

HIPAA Claim Payment Master is the best claim payment software available in the healthcare market.

Exporting claim payments with our data schema makes it easy to store your payment information. DB Connect allows you to edit and reconcile EDI 835 payments.

The complexity of a claim payment transaction is something you won’t need to worry about with our DB Connect feature. It translates 835 EDI data into any database with our proven data schema. Only when EDI information is exported to a database can you integrate your system with EDI files.

HIPAAsuite supports the following databases:

• Microsoft SQL Server
• Microsoft SQL Server Integrated Security
• SQL Server versions 2008 and up
• Oracle
• MySQL
• IBM DB2
• Advantage
• Any other ODBC compliant database

Get all HIPAA 835 data into your database with our DB Connect feature by downloading HIPAA Claim Payment Master. Download the free trial today!

Payers are now obligated to produce electronic remittance advices and the solutions out there are not all the same. We believe it should be a simple task to create an 835 file without complications. With our HIPAA Claim Payment Master you can do just that.

Import payment information into our tables and then the HIPAA Claim Payment Master will do the rest!

Find out how easy it is to create an 835 with the HIPAA Claim Payment Master. Download the free trial today!

Learn about our new feature that allows payers to adjudicate claims that they have imported with our HIPAA Claim Master. Perform all tasks of a payer with this new feature which will allow you to adjudicate and pay claims electronically. This allows for a seamless workflow to receive EDI claims, adjudicate them, provide electronic claims status and create the 835 payment advice.

The whole life cycle of HIPAA claims is covered by our suite of proven EDI products.

Manually adjudicate claims in our software and handle even the most complex scenarios such as bundling, unbundling, partial payments or coordination of benefits. Of course you can import your adjudication information as well and automate the whole process.

Pay adjudicated claims and send the 835 out to the provider while initiating ACH payments through banks.

Discover the best EDI solutions with the HIPAA Claim Payment Master. Download the free trial today!

Many payers and providers invested in image scanning system for their paper claims and often business processes rely on people being able to access the image of a submitted claim from an image store. With electronic claims this process breaks unless you use the HIPAA Claim Payment Master’s image file creation feature.

There are two image file formats to choose from, TIFF and PDF. The image of the claim as you see it on screen can be saved in those formats, including additional pages and detailed COB information. The PDF images are searchable and indexable, meaning there is some basic information of the claim saved in the file in meta data spaces that help with indexing and sorting the images.

You can even create entries in an Image index file or image index database table of every image and its relevant information, file name and location.

If you need image files of electronic claims, the HIPAA Claim Payment Master is your product.

Eliminate rejected EDI transactions. Let only data into your system that has been checked for HIPAA compliance with our HIPAA EDI Exchange module. No more "garbage in, garbage out". Discover how you can manage EDI file Transport:

• Benefit from HIPAA compliance checks.
• Confidently manage your whole EDI protocol with acknowledgements and security. (many of your trading partners will require this)
• Log all your EDI exchanges and automate your process.

EDI File Transport - Sends and receives EDI files via the File Transport Protocol (FTP). The application supports all variations of this protocol: FTP, sFTP and FTPs (implicit and explicit). PGP encryption is supported.

HIPAA Compliance Check - It has a built-in EDI HIPAA compliance engine. All incoming and outgoing EDI files are checked for HIPAA compliance. A detailed report is created for every compliance issue. Transactions that are in violation will be held back based on HIPAA rules.

EDI Acknowledgements - It creates TA1 and 999 EDI Acknowledgement files when a trading partner wants to receive them.

Trading Partner Management - Keep track of multiple trading partners with their identifiers and configurations.

Automation - Integrates with any scheduler to allow automated processing. Gets files from trading partners, decrypts, checks for HIPAA compliance and calls the appropriate HIPAAsuite application for further processing.

Logs - Incoming and outgoing EDI files are logged with compliance check results stored in the database. Troubleshooting is easy with a daily log that list all activities and error messages.

Click here to learn more .