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Home / Solutions / HIPPA EDI Solutions /
| Direct Payer Connectivity Solutions - Claims Reconciliation |
The EDIEngine Claims Reconciliation Solution (eCR) provides direct payer connectivity along
with an automated and secured way of making the claim life cycle management more
efficient and cost effective. This solution is HIPAA enabled and natively handles all data in
HIPAA compatible formats. The eCR solution is ideal for Intermediaries such as Billing Service
Bureaus and Clearinghouses and for small to medium sized hospitals who would want to
supplement their existing billing system to provide direct payer connectivity.
The main features of EDIEngine Claims Reconciliation solution are:
• Process driven approach.
• Automated processing of 837(P,I,D),835,270/271,276/
277,278/278R,997 transactions.
• Dynamic creation of 997s.
• Trading Partner profile maintenance. Profile includes all
Payer specific details.
• Multiple payer Support; Multiple legacy healthcare
format support.
• Encryption using PGP and Zip with password for security.
• Secure transportation using SFTP and FTP over VPN.
• Automated FTP uploads and downloads to and
from Payer sites.
• Reconciliation module to reconcile claims at various
points of "electronic claim life cycle".
• Payer, Provider, Claim and Service Line views and edits.
• Reports module for creating a variety of custom reports
in PDF format.
• Audit trail and viewing.
• Scheduling and Prioritization of EDIEngine Profiles.
• Command line version and automation.
• Online X12N Dictionary.
• EDIEngine X12N Framework is used internally to perform seamless translations/
encryption/transfers.
• Platform independent, Java based solution.
• Additional legacy healthcare format/encryption/processes built on demand.
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