Medicare, Medicaid and Marketplace across 18 states
Processing 10M+ Claims, Enrollments, Eligibility and Claims payment
Hospital Remittance & Revenue Management
Reconciling 20M Claim payments per year
DHCS Full File Compare
Compare Medicare, Medicaid and DHCS Full file with QNXT and update changes
Medicare HETS Real time Eligibility
Check eligibility with HETS CMS across all channels and multiple systems
Clams & Encounter Management
L1-L7 Validations, Medicare and state rules for covered and not covered code sets. Improved data quality

Solve CMS FHIR Interoperability

A fully integrated suite of Healthcare FHIR Resources

HiPaaS Platform

Services

HiPaaS FHIR Platform

HiPaaS FHIR

Healthcare CMS FHIR Platform

Enable FHIR Server with USCI and Bluebutton resources. Allergy, Observation, CarePlan, Patient, Encounter, Immunization, Location, Condition, Diagnostic Report, Explanation of Benefits, Procedure and more US Core Extensions mapped

Enable CARIN Profiles. All mandate required CARIN Profiles mapped - Explanation of Benefit, Plan, Claim, Coverage and others

Out of box DVinci use cases. Payer Exchange, Provide Directory, Clinical Use Cases, Formulary Drug and Network Implementation​

Out of box Blue button Implementation. Blue button compatible FHIR resources and server

Payer to Payer interfaces and Integration as per USCDI standards

Use Consent Management

3rd Party Consent Management. App on boarding process. Oauth security

Flows for onboarding 3rd Party FHIR Apps. Validating the app and generating Client secret key. 

FHIR Oauth Integration to access API. 

Pre-built mappings to healthcare standard extracts for claims, inpatient, professional, pharmacy, provider directory, eligibility, coverage and more.. 

HiPaaS SHIR CMS repository is in production and already tested with all leading Client Apps

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

FHIR Mongo DB

All FHIR resources mapped to Mongo DB

Healthcare Neo4j GraphDB

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

Kubernetes Cluster

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

Secure Healthcare API

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

Healthcare Interoperability Solved

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

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