HIPAA Claim Status Responder

Keeping track of individual claims uses countless hours of CSR’s time on the payers side and for the back office staff on the provider side. Leaving both sides unhappy. Transmitting the status of the claim electronically with the 276/277 set of EDI transactions holds the promise of huge savings and increases of efficiency while delivering overall satisfaction to your provider network.

The HIPAA Claim Status Responder makes it easy for payers to deliver claims status information upon request to the provider. Once a payer configures our HIPAA Claim Status Responder it will automatically handles the following:

• Receives the 276 request
• Identifies the claims
• Pulls the status information
• Sends the 277 response
• Add our HIPAA RealTime Server to enable real time transactions

For a complete EDI claims solution add our HIPAA Claim Master and HIPAA Claim Payment Master to handle the following:

• Electronic claims (837)
• Payments (835)
• Claim status (276/277)

In addition the Claim Status Responder has an intuitive interface that allows those with low volumes of claim status requests to create responses in manual mode. This mode will be ideal for troubleshooting errors and other EDI related issues with new trading partners.

The automatic response mode will make things much more efficient and truly save costs for your organization. We designed and developed our software to be simple and easy to set up with no complicated configuration steps. Keep your data in-house. The HIPAA Claim Status Responder is easy to implement and compatible with all major databases. You’re in control of your own data and it will record any incoming and outgoing transactions for transparency.

Requests and responses are saved in the database for full accountability. Outgoing files can be validated for HIPAA compliance.

Find how the HIPAA Claim Status Responder will cut cost and save your organization money. 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 Status Responder’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.

For a payer to truly benefit from the EDI 276/277 claim status transactions is by automating the whole process of receiving and responding to these electronic requests.

How does this get solved? The HIPAA Claim Status Responder knows how to turn a request into a response using your claim data. This is done after the initial setup process where you’ll connect your data with our software. Our EDI exchange module handles all the protocols, encryption and transport making this a complete HIPAA compliance solution.

Save money and time by automating with our HIPAA Claim Status Responder. Download the free trial today! >

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 >.