EDI Software Products for Healthcare

Claim Master 837.crop

HIPAA CLAIM MASTER

Master every aspect of 837 Electronic Claims.

Discover the full potential of 837 EDI Transactions:

  • Process electronic claims and export them to your database.
  • View electronic claims in the standard claim forms.
  • Create electronic 837 claims.
  • Produce claims status transactions and many more!

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OVERVIEW

OVERVIEW

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.

 

Features included with basic module:

Electronic claims are written for computers and that makes it difficult for a human to understand. People working in healthcare facilities must instantly recognize what the electronic claim is all about. How?

The HIPAA Claim Master makes it possible and convenient. The HIPAA Claim Master displays the electronic claims in the standard claim forms; the CMS 1500, the UB04, and the ADA 2012 - respectively. This is how exactly the healthcare workers used to view the information presented to them in a healthcare system. A strong advantage that only HIPAA Claim Master has the ability to offer.

Hipaa Claim Master makes it easy in the following ways:

  • Easy-to-Read Information - Non-Experts in EDI cannot understand the details of the information in an 837 EDI claims file. Worry no more because the easy viewing of electronic files in standard forms are readily available in HIPAA Claim Master. Standard forms don’t contain all the fields of the EDI 837 format, but we have created other forms to display every bit of information in a way that is easy to understand and with all codes translated.
  • Easy-to-Access Information - The HIPAA Claim Master parses one claim after another and displays it on the screen. In other words, easy access of information from a multi-page electronic claims. You’ll be able to find the correct claims with our search feature.
  • Easy-Way-to-Print Information - Of course, these images can be printed as well in exactly the same way the images can be saved as an image file. Either TIFF or PDF format will do.

Discover why the HIPAA Claim Master is the best EDI viewer for HIPAA claims. Download the free trial today! >

Print on paper any claim in the standard 837 layout.

EXPORT DATA

EXPORT DATA

Save your time and money with the HIPAA Claim Master’s ability to export electronic claims. Importing and exporting from a file to database is no easy task. EDI Translators on the market are often expensive and will take a long time to learn. Our software will export the data from electronic claims to any database. It can help providers by producing the 277CA claim acknowledgement. Needless to say, all this will improve your business productivity.

We assume that you have your own database infrastructure whether it is Microsoft SQL Server, Oracle, MySQL, IBM DB2 or any other ODBC compliant database. The HIPAA Claim Master creates two tables to where all the claim data will be exported and saved. Take the data you need for your processes and apply your own business rules.

The HIPAA Claim Master exports all the data fields that are 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!

 
 
 

MAKE 837's

MAKE 837'S

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.

 
 
 

Create PDF's

Create PDF's

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.

 
 

Claim Entry

Claim Entry

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!

 
 
 

Create 277CA

Create 277CA

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.

 
 

EDI EXCHANGE

EDI EXCHANGE

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 >.

 

STEP-BY-STEP TUTORIALS

Watch simple videos that explain how you download, install and setup our products. Discover the potential now!

WATCH TUTORIALS >

PRODUCT DOCUMENTATION

Trying to install our product? Find out how our software can work with your platform? Learn more with our in-depth documentation now.

VIEW DOCUMENTATION >

FIND PRICING

Choose the products and features that are right for your situation. Remember to check out our volume discounts. Explore your options.

VIEW PRICING >
 
Claim Payment 835.crop

Add This Product To Your Configuration

Handle Payment with the HIPAA Claim Payment Master. HIPAA Claim Payment Master brings you to the next level:

  • Create 835 payment advice transactions
  • Pay your claims with ACH
  • View and understand 835 EDI files
  • Export and save 835 EDI files
learn more! >
 

Why Choose HIPAAsuite?

  • We have hundreds of satisfied clients.
  • We helped save millions with our product solutions.
  • Full support on making transitions to our software.
  • Need a special add on? We’ll customize our software.
  • Free trial - allows a risk free proof of concept.

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