AI-powered Healthcare EDI & CMS FHIR Interop

Medicare, Medicaid and Marketplace across 18 states
Processing 10M+ Claims, Enrollments, Eligibility and Claims payment
Reduce mortality rate due to Sepsis
Run Sepsis AI model with real time Vitals, Meds, Labs data
Hospital Remittance & Revenue Management
Reconciling 20M Claim payments per year
Enable FHIR CMS Interoperability
8 Plans using our FHIR CMS solution with USCDI and Carin resources

Make Artificial Intelligence Real
HiPaaS Platform

We help you rethink Healthcare solutions

HiPaaS Platform

Services

HiPaaS Core Products

HiPaaS Solutions

Insurance Payers Solutions

Manage Claims from various Trading partners, Clearing houses. SNIP Level 1-7 validations. 999 and 277CA generation. Claims Status interfaces

Implement all real time transactions with fastet API driven interfaces integrated with QNXT, Facets and Healthedge

Manage inbound and outbound enrollments from state, Medicare and Large groups. Compare with membership data in real time and manage updates

Compare Full file from Medicare, state plans with Membership and identify changes

Implement CMS FHIR Interoperability mandate with easy interfaces to translate EDI data 274, 837 and 834 data. Easy to implement and enable with built in mappings.

Out of box integration wiht Availity Clearing house and QNXT for all transactions

Integrated with HPS enrollments for commercial and group plans to handle multiple coverages.

Hospital Providers Solutions

Reconcile 837 Claims to 835 ERA remittance and Bank files

HETS CMS real time eligibility API, MBI Lookup and  FISS/DDE emulator

Collect real time Vitals, Labs and run AI algorithms to manage cases like Sepsis monitoring, mortality rate monitoring, population health and others 

Stream real time HL7 data, FHIR resources and APIs

Context and Chat driven Mobile app integrated with MyChart. Helpful to manage telehealth and chat with clinical staff.

Collect and analyze patient data in one Graph repository. Connect all HL7, FHIR and Revenue data together.

Coding validation and claims submission, with AI driven Claims module. Reduce claims rejection. Mapped with Medicare covered vs non covered codesets.

HiPaaS Engineering

Kubernetes Cluster

Autoscale with Kubernetes. Deploy on Cloud or On Prem - AWS, Azure adn Google supported

Healthcare Neo4j GraphDB

HipaaS Store and retrives healthcare data in Neo4j GraphDB. X12, HL7, FHIR modeling

Healthcare Interoperability Solved

Support for all Healthcare data formats – EDI, HL7, FHIR, NCDP and more. using Boomi

Secure Healthcare API

Everything is Healthcare API. Access any X12, EDI segment or element via API

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