Answer: The expEDIum X12N / HIPAA Engine is a Java-based, robust translation engine that supports all the eleven HIPAA mandated transaction sets. This engine supports 837 Professional, 837 Institutional, and 837 Dental, 835, 270, 271, 276, 277, 278, 820, 834 and 997 transaction sets. The expEDIum X12N / HIPAA Engine supports HIPAA transaction set versions v4010 and v4010A1. A comprehensive API layer on top of the engine consists of over 2400 API calls covering all HIPAA transaction sets. The API is used to develop custom adapters that process any standard or proprietary Healthcare format files.
Answer:The expEDIum X12N / HIPAA Translator / Engine is a multi-threaded application using Java technologies, which ensure portability across various platforms. It has been built with world-class software development practices and quality assurance standards that ensure a high degree of flexibility, scalability and adaptability to cater to any future need. This is a high performing Engine as the X12N schemas are hard-wired in the program itself unlike traditional EDI Translators / Engines that read the mapping information from secondary store.
For more information about our expEDIum engine go to
http://www.itechws.com/x12nengineapi.html
Answer:The X12N Engine ensures “syntax” compliancy only. The "semantics" validity of the data must be ensured by the custom applications that are built around the X12N Engine API. iTech has built several readymade products and solutions around the expEDIum X12N Engine and several million healthcare claims in various formats including NSF, HCFA Print Image, HCFA/UB04 CSV have successfully been translated and have reached hundreds of payers across the United States in the last few years.
Answer:This would depend on the Transaction sets that need to be supported and the amount of edits that are required to be programmed. It would typically take 2 to 4 weeks to build a typical custom application that supports one transaction set such as 837(P). This effort would include data gap analysis, expEDIum X12N Engine API learning, custom programming, data validation (with HIPAA Validation sites) and internal testing.
Answer:No, the engine does not provide CPT/HCPCS, ICD-9 validations. This is typically provided from the applications that are built around the Translator. We do have products and solutions that perform CPT/HCPCS, ICD-9 validations. Please refer to our expEDIum Claims Portal Solution.
http://www.itechws.com/claimsportal.html
Answer:The pricing is based on per server and transaction sets that need to be supported. Typically, the pricing does NOT depend on volume of transactions, number of CPUs used and number of users. Please contact us (hyper link to http://www.itechws.com/contactus.html) for a pricing proposal with your requirements.
Answer:Typical EDI translators provide EDI Transaction set mapping on a store and use this mapping when processing EDI transactions. expEDIum works differently, expEDIum EDI Engine Architecture “hard-wires” the EDI Transaction mapping information for a given vertical or process .It provides a rich API that is used to build EDI-aware applications rapidly. It’s robust and is capable of processing several hundred thousand transactions per day on appropriate hardware.
Answer: iTech Workshop markets a variety of readymade Healthcare adapters built using expEDIum X12N / HIPAA Engine. These adapters support formats such as NSF 2.0, NSF 3.01, UB-92 v5.0/6.0, NSF 3.01 DMERC, NSF 3.20D, NSF 2.01u ERN, Envoy NSF and HCFA 1500 Print Image formats.
Answer: Yes we can build custom adapters rapidly for any other Healthcare formats as per the requirement of our clients.
Answer: The expEDIum Claims Reconciliation solution (eCR) connects existing Billing Systems and Practice Management Systems directly to Payers and makes the claim life cycle management more efficient.
For more information about our expEDIum engine go to
http://www.itechws.com/claimsreconciliation.html
Answer:The claims in the form of data on paper or in old electronic form (NSF) is processed by the Clearing houses and Billing services and passed on to the Payers .The Payers send in a positive response if the data received is in correct format. eCR solutions can be used by the Clearing houses, Billing services as well as the Payers.
Answer:iTech Workshop’s products are specifically targeted at small and medium healthcare enterprises like Medical Billing Bureaus, Clearinghouses, Payers, Hospitals and Clinics.
Answer: expEDIum solutions are Java based and platform independent they work on any platform Windows or Linux which has “Java Runtime Environment (JRE)” installed on them .The JRE can be downloaded for free from the Sun site.
Answer: Yes, our eCR solution directly connects existing Billing systems and Practice Management Systems to Payers.
Answer: Gap Analysis is used by organizations to cross-reference their legacy application data sets to the HIPAA-formatted transactions for compliance to the X12N / HIPAA Implementation Guides adopted under HIPAA.
Answer:No you don’t have to, because our adapters have a default GAP mechanism to fill in data that could be missing from the input healthcare format files but are required for generating complete X12N / HIPAA files, by default.
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Answer: Yes, we do provide programming services based on the clients requirement at additional cost. Typically, our programming services are limited to healthcare vertical and revolve around our products and solutions.
Answer: Yes, we have solutions that enable small to medium Healthcare enterprises to transform existing healthcare data to HIPAA compliant data and effectively manage the electronic claims flow and remittance flow between the various carriers and the billing entity.
Answer: Yes, we do have readymade products and customized solutions for billing services.
Answer: Yes, we do have readymade products and customized solutions for clearinghouses.
Answer: We have the architecture for a payer’s solution that is dependent on our expEDIum X12N / HIPAA Framework. We can rapidly develop a solution based on the client’s requirement.
Answer: Yes, we do have readymade products and customized solutions for hospitals and clinics. Due to a level complexity….or due to a level learning required to install and use our products we are not positioning our products for practices.
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Answer: Yes, expEDIum can function over a networked environment.
Answer: It’s quite simple to use expEDIum, we have the documentation and we can also give you a “remote demo” to make you familiar with the process of installing and running the solutions. It takes less than 30 minutes to install, run the software and process one or more files. It takes between 10 to 20 hours to setup our product to support one small practice (with 20 rendering providers) and start sending X12N / HIPAA Claims (837P/I/D) to one or more payers. Post sales, we will provide a level of support that is unsurpassed.
Answer: Yes , you can visit the Resource center section of our website to see the testimonials of our satisfied clients.
Answer: We don’t have multiple versions co-existing at this point of time, if later on at some point of time we have a situation like this (multiple versions co-existing )then we will have to check out whether there will be any conflicts.
Answer: Yes, we have an expEDIum ‘Thin’ Engine that supports only 837/835 and 997 transaction sets. We have separate adapters for handling 837 (NSFClaims, HCFAClaims and UB92/UB04 Claims) and 835 (NSFRemits) transactions.
Answer: The expEDIum Claims Reconciliation (eCR) directly connects existing billing systems and Practice Management Systems to Payers thus removing the need for clearing houses.
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Answer: Our expEDIum X12N / HIPAA Engine Architecture “hard-wires” the EDI Transaction mapping information and it delivers high performance. We have seen 200+ typical claims being (NSF 3.01 claims with multiple service lines) processed per second. Our architecture is scalable.
Answer: No, as of now we don’t have any such adapter, which can convert any file format to X12N / HIPAA. We can build custom adapters on request.
Answer: Yes, we do have adapters that connect to an ODBC /JDBC compatible database (SQL Server, MS Access). We custom program interfaces connecting our adapters to any other open or proprietary database on request, this will include additional charges on top of our standard list prices.
Answer: Practice Management Systems generate data in NSF or HCFA formats which is then taken as input by our “readymade” expEDIum adapters to generate output in the desired X12N / HIPAA format.
Answer: As t hey generate data in NSF or HCFA formats which is then taken as input by our “readymade” expEDIum adapters for conversion to the desired X12N / HIPAA format.
Answer: Yes, we have Healthcare software vendors as our clients.
Answer: Yes, we have a readymade product “NSFRemits” that transforms ANSI Remits (835s) into NSF 2.01u ERN that is supported by most accounting/billing systems. Any other interfaces/formats can be programmed on request.
Answer: Yes we have products like the ANSI creator and eCR which could be used for Claims processing, BPO etc.
Answer: Yes we do have adapters and tools that could be used to by Home billers and by Collection agencies. We can also build custom tools/solutions on request.
Answer: Send us only “deidentified” data; please DO NOT send us any claims containing live patient data. However, we do protect all data that we receive and we can sign any NDA that will protect your data if you have to send us additional data.
Answer: Several million claims have been processed using iTech’s suite of products and sent to several carriers across the USA in the last few years. You can find the current statistics on our home page.
Answer: Our adapters are used to create X12N data compatible with a variety of payers and clearinghouses across the USA and the current list of supported Payers and Clearinghouses is available on our website at our home page.
Answer: Our products/solutions support Standard secure transportation mechanisms (such as HTTPS and Secure FTP) and encryption of data using PGP (Pretty Good Privacy) and ZIP with password. Additional secure transport or encryptions schemes can be supported on demand (note this is custom work).
Answer: No, it does not. The HCFAClaims DB Adapter evaluation includes a basic database that is used for demonstration ONLY. Typically, we create custom adapters that connect to any proprietary databases and that perform the custom mapping to equivalent X12N EDI. Whatever specialities the proprietary database supports, the expEDIum custom adapter would map that to equivalent X12N EDI mapping any speciality specific data. Similarly, we can provide you with UB92Claims Custom adapter too that would work any proprietary databases on demand.
Answer: It depends on how exhaustive the database is. It typically takes between 2 to 4 person weeks to create an expEDIum Custom adapter that works with a proprietary database seamlessly creating 837(P,I,D) and other transaction sets.
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