Companies looking to automate HIPAA data processes often face multiple integration challenges such as managing inbound and outbound data feeds from external trading partners, connecting to backend EMR/EHR systems to perform patient updates, and providing a web-based reconciliation platform in the form of dashboards and web-forms to the healthcare service providers and carriers to resolve issues related to patient data or out-of-sequence policy changes.
Companies looking for an integration platform should also think about the long-term dependence on an integration platform that has the ability to scale as the number of trading partners, applications, users and the rules governing data change over time.
Adeptia offers a comprehensive HIPAA processing functionality as part of its B2B Integration Solution that makes it easier for companies to automate and process HIPAA messages. It helps you address some of the key questions such as how easy it is for a business user to setup a trading partner and onboard their HIPAA compliant healthcare data into the backend or cloud systems. It also address questions related to whether the solution architecture enable easy setup of trading partner data files (enrollments, claims etc) and has an ability to map the data if custom fields are included in the client file. Does it allow for easy management of maps that are created for different trading partners over the long run and how are changes to those maps monitored and tracked.
Here is the video link on Adeptia’s HIPAA Integrations solution : 3 minute overview of the B2B Integration platform
Another important consideration is how easily you can track the messages and the transactions that are being exchanged by the provider and the payer. Visually rich dashboards reduce time to track and check on the status of the HIPAA transactions. Things like "did they receive what we sent" should take seconds to find out rather than going through tedious process of emails and phone calls.
Now let's suppose your company has received HIPAA data from a trading partner, what if the provider didn't include the correct information about a particular patient's enrollment or claim. Maybe the data is incomplete and doesn't include the necessary supplemental documents to process the healthcare provider's request.
How does one do reconciliation on a message that is incomplete, incorrect or is out-of-sequence compared to the current policy information existing in the carrier's system of records? If the HIPAA integration solution provides an automated workflow capability with tasks that can be tracked and monitored by the business users in order to fulfill healthcare needs of an individual then that is a huge improvement in addressing the manual processes that lot of companies have in place today. Automated workflows that are fully integrated with data repositories is an important part of a comprehensive integration solution offered by Adeptia.
Let’s look at some of the important advantages of using Adeptia’s B2B Integration Solution stack: