HiPaaS Medical & Medicare modules delivers required connectivity and visibility to eligibility, enrollments, claims, and revenue data for Medical and Medicare line of business:
• Gain end-to-end visibility to enrollment status and account for each member
• Gain end-to-end visibility to capitation fees and downstream payments to providers
• Resolve errors and issues in member loading as they happen.
• Account for every claim and payment
HiPaaS Medical/Medicare modules provides:
• SOAP based connectivity to CMS / HETS, State exchanges
• X12 companion guide implementation for CMS, DHCS for 8x and 27x transactions
• Real time and batch transaction implementations
• Ability to read daily and monthly enrollment files and reconcile against EDI, Qnxt and Facets data
• Ability to read claims files and reconcile against payments
• Implementation of CORE rules
• Complete set of EDI transactions and web services
HiPaaS architecture is modernizing healthcare with magical APIs
Offered Off Premise (fully cloud based), or Hybrid – your data on premise, our processing and operations
Fully managed by our team
Built on Dell Boomi, To rated Gartner iPaaS platform
Dev & QA is done in cloud
Same operational data for internal and external users using json and widgets
Easily plugin front end analytics with customer services applications and external portals
Healthcare enterprise services, SOAP and JSON based – 100+ member, patient, claims, enrollment
Simplified connectivity services X12, HL7, XML, JSON and web services
Connect to anyone and anywhere
24x7 support and managed services
Minimal implementation and transition cost
DevCool Inc. launched HiPaaS in Q4, 2015 to address interoperability and data analytics issues within the Healthcare industry. HiPaaS is trademark of DevCool Inc.
DevCool is a trusted IT solutions provider and systems integrator to major healthcare payers and providers. We have extensive experience in the healthcare industry. We have successfully mapped and navigated the ever-changing healthcare technology landscape.
About the Team
DevCool is developed by core team of experts in HealthCare, Technology and Systems Integration.