HIPAA Claim Master

Save time and money with HIPAA Claim Master to improve business productivity. Import and export electronic claims to and from your database. Work directly with your own database infrastructure.

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

EDI Translators on the market are often expensive and will take a long time to learn.

HIPAA Claim Master creates two tables where all claim data is saved. Once data is in the tables it is easy to apply your own processes and business rules.

Export all data fields on the standard claim forms plus all other segments that have no representation on the forms, such as:

• Repricing information
• Chiropractic care
• Vision
• Home health
• Ambulance transport and other medical specialties
• COB information including detailed adjudication data for two additional payers.
• Additional identifiers for all providers and NPI's
• And many more!

Try the HIPAAsuite Claim Master now to see how quick and simple it is to use. Download the free trial today!

If you need to create claim files in 837 format and you’re concerned about the sheer complexity, fear no more. The HIPAA Claim Master offers a simple and proven process to accomplish these goals.

The HIPAA Claim Master handles everything related to EDI and files will be checked for HIPAA compliance. Acceptance by all trading partners is guaranteed.

• Any claim that comes through EDI can be exported as EDI
• Smoothly import your claims into our database schema
• Manually enter claims with no issues
• Send EDI files is a snap with built-in FTP and sFTP capabilities
• Keep data secure with the integration of PGP and open source encryption
• Produce EDI acknowledgments: TA1, 999 or 277CA (these require no more than a checkmark)

Contact our HIPAAsuite Support service to get help importing your data today! Or you can learn more through our video tutorials and help documentation.

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 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 Master is your product.

If you’re still getting paper claims and need to convert them to the 837 electronic format, our feature for entering claims will have you covered. It’s designed from the ground up around the 837. Modifying and resubmitting claims is easy now with our HIPAA Claim Master. Here’s a list of features and benefits:

• Enter claims manually into the database.
• HIPAA Compliant and validated.
• Convert manually entered claims into 837 EDI files.
• User-friendly interface for non-experts and healthcare workers.
• Design to enter compliant claims with speed and accuracy.
• Edit any claims in the database.

Discover why the HIPAA Claim Master is the best tool for claim entry. Download the free trial today!

The Claim Acknowledgment transaction, also know as 277CA or unsolicited claim status response is becoming more and more common in the provider-payer relationship.. It informs the provider whether a claim was received and can even be used to convey pro-processing and eventually processing results. Claim errors and problems can be brought up early and save on frustration.

The HIPAA Claim Master supports two distinct ways of 277CA creation.

1. As soon as the file is scanned, a basic 277CA record is created that basically acknowledges the receipt of the claim including service lines.
2. The claim record in the database has fields for claim status on the header and detail level. These fields are meant to be filled by the HIPAAsuite user through some process that has to be developed. Once the claim status fields are filled in, the process to create the 277CA can be kicked off. The files are created and sent to the trading partners involved. An option in the trading partner table determines whether such records will be created.

The second way also creates the information that the Claim Status Responder needs to dynamically respond to 276 claim status requests, in conjunction with the HIPAA RealTime Server even in CORE compliant ways.

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.