Reliability
The number one requirement for a business that moves finances between trading partners. Customers must be assured that the data is reliable.
Flexibility
Because HIPAA failed to address much of the practical operations of EDI, Payer Connection must be able to adjust to any format, any source.
Scalability/Performance
The ability to scale to multiple machines or processors when the need arises without large amounts of performance overhead is a must!
Printable Format
HIPAA compliance in minutes with Payer Connection and Pervasive integration
As an Applications Service Provider (ASP), Payer Connection offers comprehensive re-branded application outsourcing and management services. The ASP alternative provides clients with secure and comprehensive off site application or services to handle compliance requirements, and a Clearinghouse service to provide submissions of transactions between trading partners. Using Pervasive integration software technology, Payer Connection integrates and conforms disparate data from a variety of sources to HIPAA standards. Payer Connection's pcConnect, alongside Pervasive technology, creates HIPAA-compliant claims from new customers using mapping templates in only 10 minutes.
Meeting HIPAA requirements regardless of the data formats
Healthcare providers, payers and vendors of different sizes and on different platforms rely on Payer Connection to manage their insurance claims without error and in compliance with HIPAA. However, HIPAA standards are not complete standards processed the same by all carriers — the result being different variations of the same standards. Regardless, Payer Connection must manage electronic claims by editing and validating them to ensure that they are error-free, reformatting them to the specifications of the payer and HIPAA, and submitting them electronically to the appropriate payer. Dean Hill, president of Payer Connection, states, “As a clearinghouse we have the requirement to produce a HIPAA-compliant transaction regardless of the formats received or delivered. Import and export modules need the ability to scale up or out depending on the translation methods required to achieve a compliant format.”
Data consolidation for a comprehensive view of a patient's records
Another challenge Payer Connection address every day is the consolidation of data from many sources, enabling doctors and insurance providers to have a comprehensive view of a patient’s medical, billing and insurance information. Sources can include data from practice management and health information systems, laboratory and clinical information systems, patient scheduling and billing systems, enterprise information systems, and exchange and translation of electronic claims from business partners.
10 minutes to HIPAA compliance
Payer Connection integrates and conforms disparate data from a variety of sources to HIPAA standards with Pervasive integration. Payer Connection's pcConnect, alongside Pervasive technology, creates HIPAA-compliant claims from new customers using mapping templates in only 10 minutes. “For anyone familiar with the intricacies and complexities of HIPAA standards, building transformations that comply with these standards is very tedious and time consuming,” said Hill. “Using Pervasive integration technology to accomplish this in only 10 minutes is an outstanding feat.”
The Pervasive integration solution is used by Payer Connection to parse specific data and other Pervasive products to map the transformation. By doing so, Payer Connection is able to easily customize unique solutions for each new customer. Pervasive’s integration solutions deliver the ability to work with any format and gives Payer Connection a tool to re-use multiple times for each new clinic.
Pervasive connectivity, flexibility lead to successful consolidation of information
Pervasive’s solutions for the healthcare industry combine connectivity with flexibility, enabling Payer Connection to integrate formats such as HL7, HIPAA, UB-92 and CMS with applications in use. Payer Connection is also able to provide a central solution for collecting data from various patient touch points and a consolidated view of information — helping practitioners and healthcare workers make well-informed decisions.
“Without the ability to manage the translation between unstructured document formats, we would not be in business today. Using Pervasive, we built a full -scale functioning HIPAA translation engine and application from scratch in less than a year, which helps us overcome the complexity of data exchange and offers our end users the ability to manage their information efficiently and reliably. With Pervasive we continue to be an innovator in the space of delivering a comprehensive and entirely configurable business process around healthcare transactions,” Hill concluded.
Time to market improves with Pervasive integration's ease of use and reusability
Pervasive technology minimizes the time and effort to map and convert unstructured data to Payer Connection’s standard data model. Hill explained, “Years of experience with competitors' tools and complexity of managing native modules made this an easy selection. We’ve been able to shift our implementation and testing workforce from programmers to business analysts who understand the information and translation requirements. Time-to-market and empowering those individuals working directly with the customer is an essential part of any good business.”
Reusability is a another key advantage that Pervasive solutions give Payer Connection an edge over its competition. Hill said. “With Pervasive we are able to easily modify the pre-built schemas for different customers’ formats. While our competition is focused on completing the detailed programming that we effortlessly handle with Pervasive technology, we’re able to focus on producing the best processes to solve the challenge.”
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