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

12M+ MEMBERS

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

14 STATES MARKETPLACE MEMBERS

We enable all EDI transactions for Marketplace members in 14 States

18 STATES MEDICARE MEMBERS

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

50K+ PROVIDERS

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