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EDIVAL

WE FIX YOUR HEALTHCARE EDI #EDIFIX
AI driven Healthcare EDI Platform
SNIP L1-L7  VALIDATION WITH SMART CORRECTIONS

FEATURES

SNIP L1-L7 VALIDATIONS

  • Custom or out of box companion guide setup for L1/L2 Validations.

  • Configure complex validation and compare rules based 

  • Diagnosis Codes, CPT, ICD-10 and HCPCS code set  validations

  • Medicare validation with whats covered and not covered

VALIDATION TEMPLATES

  • Companion guide templates

  • SNIP L1 to L7 rules Templates

  • Compare Codesets, ICD templates

  • Covered and Not Covered template

  • NPI lookup template

  • Other data templates

  • Entire EDI data is available to access via Rest API or configured to stream on Kafka Queues

SAVE TIME

  • Save time on Reconciling data

  • Save time on data correction

  • Save time on resubmission

  • Save time on searching transactions.

NOTIFICATIONS

  • Data correction notifications

  • File delay notification

  • Validation Error notification

  • Threshold notification ( Claims rejection, etc)

SMART AI CORRECTIONS

  • Smart correction on repeating data error

  • Automated AI learning rules to correct data

  • Codes and values to mark for rejections

  • Compare with other file or external data source

  • Audit every correction

  • Manual Corrections via Work queues

FULL API INTEGRATION

  • Everything in EdiVal is accessible via API. Validation results and 999, TA1 and 277CA can be accessed via API

  • For Realtime access – Call API with the Payload data.

  • For Batch access, load the file to S3 bucket and call the API with filename. 

  • API response includes EDI Validation Results:

    • 999 Response

    • TA1 Response

    • HTML with error

  • Trading Partner Information  – You can use it to validate Trading partner

  • API are available for access claims, enrollments and all EDI data – validated or errored 

  • APIs are available to run complex query and lookup any data EDI data element

SINGLE VIEW OF EDI

  • Powerful dashboard gives audit tracing across files and transaction level

  • Plugin any BI tool to write your own analytics

  • Real time visibility to data as it is validated and Loaded

  • Realtime visibility to edi errors and corrections

  • Audit trail of every change

  • Same data view for edi analyst and customer service

 SUPPORTING HEALTHCARE EDI TRANSACTIONS FOR MEDICARE & MEDICAID IN 18 STATES 

HIPAA EDI
TRANSACTIONS

FOR PAYERS AND PROVIDERS

EDIVAL supports both inbound and outbound for all EDI Transactions. EDIVAL comes with L1-L7 validations, custom process flow, workflows and smart corrections. 

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CASE STUDIES

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12M+ MEMBERS

We validate Claims and Remittance for Largest Plan with 12M+ members

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14 STATES MARKETPLACE MEMBERS

We enable all EDI transactions for Marketplace members in 14 States

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18 STATES MEDICARE MEMBERS

We enable all EDI transactions for Medicare & Medicaid members in 18 States

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50K+ PROVIDERS

We are providing real time Eligibility data to 50K+ Providers

 SUPPORTING HEALTHCARE TRANSACTIONS FOR 20M+ MEMBERS

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GET STARTED

Invest your time where it's needed. Set it up once and auto-scale

HIPAAS supports AWS Cloud, Azure or GCP or On-Prem for Enterprise customers. 

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