HIPAA Eligibility Checker
It’s time to confirm patients benefits electronically.
Providers will save countless hours of back office time by switching to electronic eligibility inquiries. Exchange the 270/271 eligibility transactions even in real-time to take advantage of requirements that payers have under HIPAA and the ACA. Discover our user friendly interface for handling manual and automated requests and work with the responses confidently.
Add-on Modules
Overview
Before starting a treatment, providers need to know the insurance coverage of a patient by a carrier. Many providers have staff to find out the benefits of a patient. The HIPAA act created the 270/271 EDI transactions to make this exchange of information electronically. Payers are required by law to respond to electronic Eligibility requests and the healthcare industry is pushing for the responses to be sent in real time.
Avoid annoying IVR systems and spending countless hours collecting information over the phone with our HIPAA Eligibility Checker. It has enabled providers to create electronic request in the 270 format and to receive and translate the 271 response.
See the features of the HIPAA Eligibility Checker:
- User friendly interface
- Manually create 270 electronic requests
- Creates 270 electronic request files from database
- Views 271 Eligibility response records
- Saves 271 responses into your database
- Combines requests and responses
A module that is optional and works with the HIPAA Eligibility Checker is our EDI Exchange. See here some of the following features:
- Manages all insurance carriers
- Handles encryption and transport
- Automates processes
- Includes CORE client for real time transmission
- Supports MIME and SOAP
Save money and time with our HIPAA Eligibility Checker. Download the free trial today!
Features included with the basic module:
- Create 270 requests
- Read and parse 270 status requests
- View and print 271 responses
Connect To Your Own Database
The HIPAA Eligibility Checker will help hospitals handle larger volumes of eligibility requests by connecting to your database. After a one time setup process of importing some basic information on the patient, the HIPAA Eligibility Checker will convert this data into 270 Eligibility request files and send them out to carrier. The responses will be received and exported into different data tables for access by your system and processes.
Add EDI eligibility with our HIPAA Eligibility Checker. Download the free trial today!
Create PDF'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.
REALTIME CLIENT
The real-time client enables communications with CORE compliant SOAP or MIME servers.
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.
ADD THIS PRODUCT TO YOUR CONFIGURATION
Handle payments with the HIPAA Claim Payment Master.
Create 835 payment advice transactions
Pay your claims with ACH
View and understand 835 EDI files
Export and save 835 EDI files
Why Choose HIPAAsuite?
SINGLE USER
Perfect for independent practices. Professional grade tools at an accessible price point.
Multiple Users
The first license at regular price, plus 60% off all additional seats in the same organization.
Most PopularSite License
Unlimited enterprise-wide access at only 6X the single-user cost. Unbeatable ROI.
