hcfa2HIPAA™ is the premier claims transformation solution enabling any claim processor, such as health plans, delegated groups, and other claim intermediaries to DIRECTLY collect, process, and exchange quality-controlled, HIPAA compliant claims from ANY HCFA claim submitting source.
The right tool for the right job. hcfa2HIPAA™ bridges the processing gap between healthcare claims processors (claims intermediaries and health plans) who need process-ready formatted transactions and healthcare providers who submit claims generated by over 1,000 different provider practice management systems (PPMS). Since HCFA claims are images, not data records, they do not easily convert into process-ready formats such as NSF or ANSI. Additionally, HCFA formats vary based on individual provider desktop system configurations (e.g., PPMS, operating systems, printers, etc.) and are subject to ongoing changes requiring modification and conversion updates.
Faster to scale, uniform implementation. hcfa2HIPAA™ is a processing application composed of the h2H-asp.net™ website and the h2H-host™ application residing at our customers’ processing locations. h2H-asp.net™ (operated by Transaction Methods, Inc.) creates h2H-objects™ . These are the transformation codes that enable "on-the-fly" transformation of HCFA claims into process-ready transactions. h2H-asp.net™ has an existing library of h2H-objects™ for over 200 PPMS vendors. h2H-objects™ for new PPMS are created in minutes.
All the advantages, no disadvantages. hcfa2HIPAA™ has many advantages over other solutions that were not designed to specifically solve the "HCFA Image" conversion problem. There is no expensive operating environment, no specific technical resources, no extensive training, no performance issues at high volumes, and no invasive requirements to the systems and procedures at provider sites, claim intermediaries and health plans. Since 1997, millions of HCFA print image claims have been transformed by hcfa2HIPAA™ technology into process-ready, formatted transactions.
In addition to "HCFA Image" claims hcfa2HIPAA™ enables our customers to transform additional inbound claims from UB and NSF formats. One solution to transform and manage inbound claims in HCFA 1500, UB, and NSF formats!
Customer control and management. h2H-host™ is easy to use and allows our customers to manage and maintain the hcfa2HIPAA™ process. h2H-host™ includes a graphical user interface (GUI) providing access to end-to-end balancing and controls and file auditing from HCFA images to ANSI 837 formatted transactions. An integrated desktop browser is available to acquire and transfer claims from the provider desktop to the claim intermediary or health plan.
Getting started is easy. After connecting to h2H-asp.net™, the customer downloads the h2H-host™ application. Through the GUI, the customer sets up routings, directories, error notifications, values, and output directories within its operating environment.
When a provider site (or any claim submitting site) is established for claims processing, the initial HCFA claim file is submitted to h2H-asp.net™ where a h2H-object™ is created, tested, and certified against industry edits and/or customer specific edits (optional) and securely transmitted back to h2H-host™ that: (1) establishes the provider site; (2) registers the h2H-object™; and, (3) activates the provider site for submitting production claims.
Processing claims is easy. Once the h2H-object™ is set-up, the provider site can send electronic claims to the customer via any manner (e.g., executable, browser, Internet, dial up, etc.) established by the customer.
When claims are received at the customer for processing, they are routed to a h2H-host™ directory. At this point h2H-host™ balancing and controls begin and the submitted claims are executed through the following process: (1) the claim file is selected; (2) the specific site h2H-object™ is located; (3) the h2H-object™ performs transformation from HCFA image to HCFA Data Record (HDR) to ANSI 837 formatted transaction; and, (4) the formatted file is moved to a customer specific directory for processing in accordance with the customer’s normal processing routines.
Managing the process is easy. Through h2H-host™ customers can: (1) monitor processing dates, files, transactions, and dollars; (2) view results for specified time periods; (3) view and/or modify error notification addresses (e-mail); (4) view and/or modify the status of submitting sites; (5) view and/or modify routing (post conversion) to specified directories; (6) view and/or modify field values to specified preferences; (7) view the native HCFA data; (8) view the transformation to HDR; and, (9) view the conversion to ANSI.
After a provider site is in production a h2H-object™ may need to be updated due to changes in the provider desktop configuration. h2H-host™ allows for the deactivation of a submitting site. As in the "Getting Started" process described above, the changed HCFA file is submitted to h2H-asp.com™ and a new h2H-object™ is created, tested, certified, secured, and transmitted to h2H-host™ at the customer’s processing location.
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