274 Provider Directory

EDI 274 is an electronic document used to transmit demographic and provider network, practitioner data qualifications about healthcare providers. This transaction set is mainly used to maintain a provider database.

HiPaaS Provides provider directory creation mappings and conversion to EDI along with validation of data

HiPaaS EdiVal Provider Dashboard

For Insurance Companies

1. Get Provider Network Data Generate provider directory data from network database or from QNXT, or Facets,

2. Create the 274 EDI directory and Validate Validate the provider directory SNIP L1/L2

3. Send EDI 274 to CMS, State and Providers Send outbound 274 Provider directory to state, CMS and providers

• View Directory online View the directory and searchable via HiPaaS portal or integrate to Member and Provider Portal

• Provider Directory on Kafka Stream Provide access to provider directory via Kafka stream

• Provider Directory API and FHIR Mappings

Access Provider directory via API. Convert EDI to FHIR and load in FHIR

• EDI to FHIR mapping Map the 274 data to FHIR US CORE and available to search via FHIR API or Restful API