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

We envision HiPaaS to focus on improving patient and revenue outcomes by implementing AI driven use cases

HiPaaS Core Products

Enterprise Platform

Healthcare Cloud

CMS Server

Healthcare Interfaces

Patient Data

Single View of Data

HiPaaS Solutions

Insurance Payers Solutions

Claims EDI Management

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

Realtime Eligibility, Claims Status and Pre Auth

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

Enrollment Management - Medicare & Commericial

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

Full File Enrollment Compare

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

FHIR CMS Interoperability

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.

Availity Integration

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

HPS Enrollment Integration

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

Hospital Providers Solutions

Remittance Reconciliation

Reconcile 837 Claims to 835 ERA remittance and Bank files

HETS Medicare Eligibility API & FISS/DDE

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

Clinical Artificial Intelligence Enablement

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

HL7 , FHIR & Rest API Integration

Stream real time HL7 data, FHIR resources and APIs

Mobile and Chatbot

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

Clinical Datawarehouse

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

Claims & Revenue Management

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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