HiPaaS EDI
Make Artificial Intelligence Real
Simplifying Healthcare EDI
We help you rethink Healthcare solutions
About
Why Choose HiPaaS?
- State of the art solutions for Revenue Cycle Management, Clinical AI Enablement and more
- Better work queue management
- Solve the problem of getting paid in a cost effective manner
- Premier Provider of Solutions in the Payer and Provider space
We envision HiPaaS to focus on improving patient and revenue outcomes by implementing AI driven use cases.
Sandeep Deokule
HiPaaS CEO.
Manage Inbound or Outbound Claims 837 I, P, D from various Trading partners, Clearing houses. SNIP Level 1-7 validations. 999 and 277CA generation. Claims Status interfaces. Quickly reconcile rejected claims with mechanisms to route and automate claims edits
277CA transaction response
999, TA1 Responses Account for every $ of claim payment. Reconcile 837 to 835 Payments
Manage Outbound Encounters Submission to State or Medicare, Medicaid. SNIP Level 1-7 validations. 999 and 277CA generation. Outbound Encounters: Generate Encounter data/files from QNXT/System of choice or a staging database. Send validated encounters to state with custom edits. Hold and fix encounters errors. Load responses from different States (EVR, 999, 277CA, 835, text reports). Keep up to date on State validation edits changes
Match your encounter edits to inbound Encounter error corrections and Encounter Reporting.
Manage Inbound or Generate Outbound 835 Claims Payments. Reconcile with 837 Claims. Reconcile with Remittance and Treasury and Lockbox.
Implement real time transactions with fastest API driven interfaces integrated with QNXT, Facets and Healthedge for Claims Status 270/271, 276, 274, 278 Pre Auth
Implement 275 Claims Attachments and Clinical attachments
Manage out of box 999, TA1 and 277CA transactions
Out of box integration wiht Availity Clearing house and QNXT for all transactions
Implement all real time transactions with fastest API driven interfaces integrated with QNXT, Facets and Healthedge.
270/271, 276, 274, 278 Pre Auth
Manage inbound and outbound enrollments from state, Medicare and Large groups. Compare with membership data in real time and manage updates. Manage Add, terms, changes, voids, term by absence and various overlapping scenarios. Business workflow UI to pre-scrub and validate prior to loading into membership system
834 Enrollment Validation & Processing Compare & reconcile member data against any membership system. Automate your membership updates including retro changes
Ability to fix errors on file and re-submit with configurable validations including: PCP, NPI, zip code vs state/address, Rate code comparison, Aid code, Dual plans validation
Compare Full file from Medicare, state plans with Membership and identify changes
Implement Provider Directory and directory submission
Robust Prior authorization solution for real time and batch 278-11 and 278-13 processing and inquiry. Pega integration
Manage 820 Payments and reconcile with enrollments data
Integrated with HPS enrollments for commercial and group plans to handle multiple coverages.
Manage various other formats for claims, patient data
