EDI Software Products for Healthcare

Prem Payment 820.crop


Stay on top of premium payments

The 820 transaction set contains premium and policy payment information. It is the perfect tool for anybody dealing with state or federal Health Insurance Exchanges (HIE) and handles all 820 operations.




The HIPAA 820 transaction set handles the communication between a sponsor that is an entity that pays for someone's health care, and another entity that manages health care benefits, such as an insurance company.

For example a large employer that has a contract with an Insurance company or a government agency that handles social and health benefits will use the 820 transaction to manage premium payments. This information can either be very detailed and contain demographic information on each individual that is covered or just contain a summary of the payment for all members.

Health Insurance Exchanges (HIE) use a slightly different version of the standard HIPAA 820. Instead of the X218 the X306 is used to transmit payment information to the carriers. The HIPAA Premium Payment Master supports both versions transparently.

Viewing premium payments:

  • View the data in forms on the screen
  • Print it to paper
  • Create an image file (PDF and TIFF)

The cryptic EDI information is translated and each element in the EDI file is properly displayed. A perfect solution for those with small volumes of 820 files who can use manual entry into their accounting system.

Exporting premium payment information in to any database is easy with the HIPAA Premium Payment Master. All the information is clearly saved in our schema and we support the following databases:

  • Microsoft SQL Server
  • MySQL
  • Oracle
  • DB2
  • Many more databases

Do you need to make 820’s to inform a carrier of payments made? From our data tables we create 820’s EDI files, encrypt, send and handle all the protocols for you. Our HIPAA Premium Payment Master is the best tool to handle all your 820 operations.


Features included with basic module:

Viewing premium payment information that is locked up in an 820 EDI file is a tedious task and even really difficult for the most experienced. The data is often abbreviated and represented by cryptic codes that have to be looked up in cross reference tables.

Our HIPAA Premium Payment Master displays the information in a 820 file in a clear way with the codes translated for easy reading. There are 2 distinct types of the premium payment transactions, the individual policy and the summary statement for group policies. A perfect solution for those with small volumes of 820 files who can do manual entry into their accounting system.

Discover why the HIPAA Premium Payment Master is the best tool for viewing electronic premium payment records. Download the free trial today! >

DB Connect

Connect to your own database

Exporting EDI files into a database should not be difficult.

DB Connect feature allows HIPAA Premium Payment Master to store the 820 X12 transaction data into a database. Each individual record and element in the EDI file is saved in our schema with field names straight out of the EDI implementation guide.

DB Connect feature will support the following databases:

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

It’s ideal for those who need the data in their system. Great for large volumes of HIPAA 820 EDI files.


Make 820's

MAKE 820'S

For larger organizations and agencies who need to create an 820 EDI file to inform a carrier of a premium payment the HIPAA Premium Payment Master offers a clear path to accomplish this task. Using the same database schema that we use for the export of premium payments, we developed the reverse process to create 820 EDI files from database records. All you need to do is populate our tables from your system and our software handles the rest.

Including the EDI Exchange module here are the main capabilities:

  • Create the 820 file
  • Check for HIPAA compliance
  • Supports secure FTP
  • PGP encryption
  • Creation of 999 files
  • TA1 files
  • Trading partner management

Find out why the HIPAA Premium Payment Master presents the easiest and most affordable way to create 820 EDI files. Download the free trial today! >


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 Premium 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.


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 >.



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Claim Master 837.crop

Add This Product To Your Configuration

Handle Claims with the HIPAA Claim Master. We have hundreds of satisfied clients who:

  • View electronic claims in any format
  • Export claim data to any database
  • Create 837 claim files
  • Create claim image

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