EDI, Transactions Testing, and Clearinghouse Vendors

• Accent Communications Ltd.
Product: Accent Transformation Gateway: Transform EDI, HL7, SWIFT, CSV, FIX or any flat file to XML, CSV for database or ecommerce site upload or any other data format for small bucks.
The Accent Transformation Gateway is designed to transform any delimited or plain positioned text data source in another data format or in plain XML. With the Accent Transformation Gateway you can receive an EDI file transform it into a CSV and upload it in a database with a SQL loader. The Accent Transformation Gateway will do the translation on the fly once you have customized it. The customization can be done without any programming knowledge.
The Accent Transformation Gateway is written in 100 % Java so that the transformation can happen on any platform. The customization functions via a graphical user interface. The Gateway once started will function as a service in checking for any new files automatically and after transformation placing it in another folder. If you want to run Accent Transformation Gateway under Windows you can use Jserv to run it as a service that will automatically start with the server.
• CAQH/WEDI
The resource for information on health plan electronic transaction changes in 2003.
Created by the Council for Affordable Quality Healthcare (CAQH) and the Workgroup for Electronic Data Interchange (WEDI), this site intends to ease potential provider confusion related to 2003 HIPAA-mandated changes in health plan-provider electronic interactions. Designed as one common resource for providers and plans alike, this site gives providers the latest information on health plan transaction changes and equips health plans with simple tools to communicate these changes to providers.
CAQH and WEDI created two tools to help health plans communicate to providers their implementation of the HIPAA X12N and NCPDP transaction changes: the
Transactions Testing and Implementation Schedule Template and the
"Best Practice" Companion Guide Template.
Health plans, system vendors, provider representatives and healthcare/HIPAA industry experts provided input during the development of these tools.
• Claredi
Claredi provides the most comprehensive HIPAA EDI transaction testing and certification solutions to help healthcare providers, payers, and clearinghouses become HIPAA compliant. With our Claredi^SM Classic, Faciledi^SM, and Communedi^SM services, we offer the easiest, most efficient path to HIPAA EDI compliance.
• Data Junction
Data Junction’s healthcare solutions combine connectivity with flexibility, enabling healthcare companies to integrate formats such as HL7, HIPAA, UB-92 and CMS with applications in use. Data Junction provides the central solution for collecting data from various patient touch points, presenting a consolidated view of information to assist practitioners and healthcare workers in well-informed decision making.
• Data Trans Solutions, Inc. - Quality EDI and B2B Solutions
DataTrans has the infrastructure established and the requirements in-house to fulfill your HIPAA EDI requirements. The deadline for these EDI requirements is quickly approaching. Contact DataTrans to sign up for our services and let us provide your HIPAA EDI solution.
• EDIdEv LLC - EDI Development for Programmers
EDIdEv LLC is an established company with a mission to create cost-effective and easy means of EDI communication. We believe that EDI should make transactions between companies easier and not harder; more economical and not more exorbitant, more dependable and not more questionable.
Product: EDIdEv Framework EDI 4.2
EDIdEv Framework EDI (FREDI) is an EDI Development Kit that includes an ActiveX/COM, and application utilities to facilitate the development of EDI applications.
The FREDI ActiveX/COM provides a set of EDI functions and commands to programmers; resulting in writing less code and therefore faster EDI application development. FREDI has the following capabilities:
Constructs EDI files - By simply calling a "save" method, FREDI takes the values that were assigned to its properties to generate a well formatted EDI file.
Parses EDI files - FREDI breaks EDI files down to manageable data elements.
Creates Acknowledgments - FREDI can automatically generate a Functional Acknowledgment (997) or Syntax Messages (CONTRL) at the same time when it is parsing an EDI file.
Supports X12.58 Security Structures - FREDI has commands for encrypting, compressing, authenticating and assuring EDI files.
Supports X12 and UN/EDIFACT standards - FREDI uses Standard Exchange Format (SEF) files to support all versions and Transaction Sets of both X12 and UN/EDIFACT EDI standards.
• Edifecs
Edifecs for HIPAA - X-Engine, CommerceDesk and SpecBuilder
The Edifecs HIPAA enablement solution empowers healthcare organizations to quickly reach HIPAA compliance and to then maintain it in the face of ongoing change. Together the Edifecs HIPAA solution set provides the most complete set of HIPAA enablement technologies available.
HIPAA Features: Providers, Payers, Clearinghouses, Sponsors and other HealthCare Organizations can all benefit from the following scenarios. Data Testing, Validation & Certification. The world's leading validation technology for Testing & Certification. Data Conversion & Transformation. HIPAA translator as an embeddable component for processing inbound and outbound HIPAA transaction data. Trading Community Testing & Deployment. A web based self-service partner enablement service for testing & validation. HIPAA Guideline Specialization. A complete development environment for authoring, extending, customizing and maintaining HIPAA transaction sets. Test Data Generation for testing with trading partners & internal systems.

Free HIPAA Transaction Testing & Certification Service
Edifecs, a leading provider of technology solutions for e-commerce community enablement, is providing free HIPAA transaction testing and certification on its online community, HIPAADesk.com, which today serves over 1,500 healthcare entities. This new service will enable the healthcare community to achieve and demonstrate compliance with the ASC X12 HIPAA Implementation Guide requirements for transactions mandated by the Health Insurance Portability and Accountability Act.
An independent study presented at last November’s WEDI-SNIP Summit found the two major fee-for-testing providers to be comparable in quality with Edifecs’ free testing service, HIPAADesk.com. This service comes just in time to help the healthcare industry meet the April 14 deadline to begin testing. This service will allow healthcare entities -- including hospitals, doctors’ offices, health insurance companies, clearinghouses, vendors and others -- to do the following:
1. Obtain a comparison report of the 4010 and the addenda for each of the HIPAA implementation guidelines
2. Test data files against HIPAA Implementation Guide requirements
3. Certify that the files submitted to HIPAADesk.com meet the format and content requirements for HIPAA Implementation Guide compliance using WEDI type 1 – 7 edits
4. Share that certification with other interested parties
5. Focus financial resources on business-to-business (provider-to-payer) testing, where the real benefits of HIPAA come to fruition
• EDI Healthcare - Free Electronic Medical Claims Processing (A Division of Managed Care Systems, Inc.)
The MCS Clearinghouse was established to provide a single distribution channel for the flow of medical information and data between medical providers, facilities, other clearinghouses and insurance payers with diverse data organizations. By adopting an "all payer" platform, MCSI gave providers the ability to outsource paper claim printing and gave large volume trading partners a cost effective resource for expediting their paper claims. Managed Care Systems, Inc. took another giant step and established itself as a HUB for the entire spectrum of medical EDI. By expanding its translation and mapping capabilities, MCSI has created a resource greatly sought after by physician organizations (IPA's, MSO's, etc.), payers and clearinghouse trading partners that desire connections to one another.
• EDI Specialists
EDI Specialists has established a focused line of business that deals specifically with the growing Electronic Commerce and EDI needs of our clients, especially Health Care clients required to comply with HIPAA mandates. This service combines comprehensive assessments; gap analysis and remediation; EDI transaction development; contract mapping; consulting; training; and staff augmentation; with technology experts who can effectively manage and deliver project solutions for all aspects of HIPAA, EDI, and application systems integration.
• EHNAC - Electronic Healthcare Network Accreditation Commission
EHNAC accredits entities engaged in ehealth activities of electronic healthcare transactions and management of healthcare information on their ability to meet high quality performance standards in the areas of privacy, security, technical performance, and business practice. EHNAC’s self-assessment and site review processes assist entities in meeting industry-defined performance standards, which include, but are not limited to, Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
• FlexTech, Inc. - HIPAA Monitor EDI
FlexTech, Inc. has provided a number of EDI services over the years to various types of healthcare organizations. With respect to HIPAA, we offer the following experience/skill sets to support our ability to assist with your HIPAA EDI requirements:
1. HIPAA Compliant ANSI X12N (ver. 4010) file development
2. ECMap by Sybase implementaion (HIPAA compliant data mapper)
3. Microsoft BizTalk implementation
4. Mercator Mapping software experience
5. ANSI X12 programming and design experience for provider, member and claim files
6. Programs (translator) for ANSI standard X12 834 and 837
7. Medicaid EDI processing
8. Extensive EDI programming for multiple lines-of-business including Medicare accretion/deletion processing
9. EDI Two-way Pharmacy interface design and development to operate between client and drug vendor
10. NSF (National Standard Format) Claims extract development
11. Custom programs to handle incoming and outgoing UB92's and HCFA 1500's from clearinghouses
12. Clearinghouse program development and support
13. EDI extract/reformatting program development for a major software vendor's subsystems, including Membership/Eligibility, Claims, and Provider
• Foresight Corp.
Since 1990 Foresight has offered easy-to-use business-to-business software that enables electronic commerce between trading partners of all sizes. Recognized for its innovative products and superior customer support, Foresight provides productivity, data transformation and data validation solutions to more than 5,000 users from 60+ health care organizations and many Fortune 500 companies.
HIPAA Validator Suite: Desktop, Online, Server, Instream & EDISIM.
To help health care organizations and your partners achieve HIPAA transaction compliance, we're introducing the HIPAA Validator™ solutions suite, a family of products that offers you total flexibility in validating the compliance of your data and your partners' data.
• GEFEG USA
HIPAA Accelerator: The eB Implementation Accelerator GEFEG EDIFIX®, the world's most successful pre-EDI software, is presently being enhanced to accelerate HIPAA EDI implementation. It will check your data for HIPAA compliance on SNIP WEDI levels 1through 6 and you can translate HIPAA transactions into comfortable human readable formats. Available as Web-based service and/or as software tool on your desktop.
GEFEG EDIFIX® for HIPAA on your desktop will provide you with the flexibility of the world's most comprehensive pre-EDI software:
• GXS - Global Exchange Services
GXS has over 30 years' experience serving the needs of the healthcare community. We also have a proven history of delivering cost-effective, easy-to-implement EDI and other e-commerce solutions. We can connect you to your business partners, streamline your daily operations, and integrate information across multiple systems and applications. At the same time, we'll help ensure that your transactions are HIPAA compliant.
• HCEC - Health Care EBusiness Collaborative (formerly HEDIC - Healthcare EDI Coalition)
HCEC is the non-profit association for the collaborative improvement of electronic business (EBusiness) efficiencies in the health care industry. HCEC Membership is open to all stakeholders in health care EBusiness development and operations. HCEC is a Resource Center for Health Care EBusiness Improvement. We provide: NEWS & UPDATES; ANSWERS & RESEARCH; EDUCATION & INSTRUCTION; PLANNING & IMPLEMENTATION RESOURCES; SUPPORT & COLLABORATION.
• HDX - Healthcare Data Exchange
- comprehensive electronic transaction services for the health industry
Healthcare Data Exchange (HDX) is a leading electronic information exchange services company providing comprehensive electronic transaction services designed for the health industry. Headquartered in Exton PA, we are committed to the delivery of quality, value-added services that help our customers lower costs, improve quality, and increase efficiency.
Founded by SMS, (now Siemens Medical Solutions), HDX has developed and implemented proven Electronic Data Interchange (EDI) services since 1989.
Our solid foundation is built on the unique advantage of years of experience in both healthcare and information technology. HDX structures its transaction services using advanced and proven application, messaging, communications and networking technology.
HDX is uniquely positioned to continue to provide the healthcare marketplace with EDI transaction services that satisfy the EDI needs of our providers, payers and third-party healthcare customers. EDI is a strategic differentiator of the successful healthcare organization and has become an absolute requirement to meet the needs of the rapidly changing world of healthcare. HDX is committed to supporting and serving the industry in this critical area.
• Healthcare Software Solutions
Product: EDI Translator: Our HIPAA Translator is a windows-based B2B Integration software solution and HIPAA translator tool. This tool provides a quality, cost-effective solution tailored to avoid high consultancy, development and deployment costs that are resident in most EDI solutions. It facilitates data transfer between disparate databases in an easy-to-deploy, non-invasive, low-maintenance process. Healthcare Software Solutions offers a translator solution for both large and small healthcare organizations which are platform independent and can work with any server.
• HIPAA Banking
The Banking Industry HIPAA Task Force is a joint initiative of NACHA - The Electronic Payments Association and the American Bankers Association to assist financial institutions in understanding HIPAA's impact on payment processing and in meeting the demands of their health care customers.
The banking industry supports the goals of the HIPAA to standardize and automate the processing of health insurance transactions. The banking industry also supports the goals of HIPAA to establish privacy and security standards that safeguard the confidentiality of protected health information. The banking industry stands ready to assist the healthcare industry in meeting this public policy goal by providing Automated Clearing House (ACH) electronic payment and remittance data processing and services.
Financial institutions have been processing a large and growing number of financial electronic data interchange (“FEDI”) transactions for years, including healthcare payments and related addenda. Moreover, the banking industry’s unique capability to keep “dollars and data together” - i.e., payment-related information flowing as addenda with the payment entry itself through the ACH Network - is consistent with HIPAA’s objective to reduce costs and simplify administration.
• HIPAA.org
- EDI Practice Management System Directory
This Directory is intended to assist medical practices locate important information, supplied by practice management and billing systems vendors, on HIPAA transactions and code sets implementation, testing, and certification. Visitors should read the Terms and Conditions governing their use of this website. This directory is for informational purposes only. The individual vendors have supplied their own information about their companies and products. The organizations bringing you this website do not endorse the companies listed or verify the information posted, but we encourage practice management systems vendors to register and provide information regarding their HIPAA-readiness that will guide medical practices' business decisions. To interpret correctly the technical information presented by vendors, it is important that medical practices begin by reading the Instructions and other hyperlinks located at the top of each page in the Directory. Then access information about a particular product by clicking on the vendors below.
• HIPAA Suite
HIPAA Suite is a complete EDI front-end application for payers in the healthcare industry. It is a low-cost, off-the-shelf, self contained solution for small-to- medium sized payers that allows the exchange and processing of HIPAA-mandated EDI transactions and the achievement of HIPAA compliance at a very affordable price and with a minimum of disruption to existing operations.
HIPAA Suite is designed to provide for: Complete HIPAA Transaction Set Compliance; EDI Healthcare Transactions with any Trading Partner; Open Databases that contain all the Elements of an EDI Transaction; Adjudication and Paying of Claims with HIPAA compliant codes; Automatic responses to Claim Status and Eligibility Requests; Screen interfaces to respond in detail to EDI requests and Operations, like Payment Advice, Claim Status, Eligibility data or Authorizations and Services Review; Setting up Trading Partners and Payees for different communication methods; 50+ HIPAA compliant code sets and their maintenance; Open interfaces like ODBC, API calls or XML to enable the integration with existing systems.
• HIPAA Testing
- "Accelerated Testing for HIPAA Compliance"
Our proven quality assurance and software testing processes make coming into HIPAA conformance a much easier process. No need to learn awkward test file tools or pay for expensive training classes, we walk you through the conformance process and take the guess work out of testing. We have over 100,000 EDI test files and are building more everyday to help you test your systems. We can also create thousands of test files using your production data. Whatever you need we have it, test plans, test scripts, test files, automation tools so you can test faster and more accurately, help with configuration management, any testing requirement you need...we are here to help.
We've been involved in testing and certifying software for Fortune 500 companies since 1992. We can test your transactions for conformance and ensure that your application systems are operating properly.
Services: Third Party Services; Free EDI Validation Testing; Test Data and Test File Services; Trading Partner Community Enablement; Quality Assurance Consulting Practice.
Our multi-level programs are designed to walk you through from unit testing to trading partner testing and then into production. Partner with us today and start clearing away the confusion and obstacles involved in HIPAA conformance testing and EDI validation.
• IBM - WebSphere Business Integration for HIPAA
Our HIPAA resources -- including proven software, HIPAA professionals, healthcare specialists, and electronic security professionals -- offer worldwide experience and proven success in providing solutions for clients in a broad range of industries. Calling upon our substantial expertise in electronic data interchange (EDI), security, privacy, code sets, and system integration, IBM can work with your HIPAA project team to help prepare you organization to meet the HIPAA mandates.
IBM WebSphere Business Integration for HIPAA offers solutions that meet healthcare organizations' HIPAA needs and deliver improved results through implementation of a proven, reusable and supportable integration technology. The core of the IBM solution is WebSphere Business Integration for HIPAA, which supports the 12 HIPAA EDI transactions, and the mandated NCPDP formats. WebSphere Business Integration for HIPAA allows healthcare companies to securely exchange transactions in simultaneous real-time and batch environments. IBM delivers pre-built HIPAA standard templates and process automation collaborations including: claims submission, policy additions, and price quoting. Built on open standards, IBM WebSphere Business Integration for HIPAA allows customers to leverage their existing HIPAA investments and skill sets -- reducing TCO and reducing risk.
• InfoCon Systems - HIPAA EDI Services
HIPAA Tools: 837 Print Utility
HIPAA Services: Compliance Service, Data Conversion, Legacy Conversion, HIPAA Security
HIPAA Consulting
• IPNet
BizManager™ HealthLink™ Enabling the secure exchange of financial and patient transactions.
While rising healthcare costs can be attributed to many factors, administrative inefficiencies, both internal and external, account for a sizable portion of the increase. Whether you're an insurance company, hospital, physician or supplier, you can cut significant costs by exchanging transactions electronically. BizManager HealthLink is designed to help organizations reduce operational costs and meet the HIPAA transaction and security regulations by enabling the secure exchange of claim transactions between partners across the Internet. It also serves as an interfacing engine, providing centralized administration of all healthcare applications (claims, procurement, clinical). The result? Timely, accurate information delivered to all parties at dramatically reduced cost.
• IVERTEX
Ivertex has years of experience in the healthcare systems, electronic medical billing, and Internet EDI arenas. We sell specialized HIPAA compliance products, including a unique product that integrates with your existing practice management system to enable direct electronic medical billing. We also provide an open source secure messaging tool to enable providers and payers to transfer files with HIPAA security compliance. Our Healthcare Technology Services include HIPAA consulting and auditing services to help you bridge the HIPAA gap through training and on-site system development services.
Snap-in HIPAA Transactions Compliance - Product: SolAce Electronic Medical Claims is an integrated solution for HIPAA transaction compliance and electronic medical claims submission available to providers across the United States and in Guam, Puerto Rico, The Virgin Islands, and other territories. SolAce enables you to submit claims electronically without any per-claim or per-provider fees! Turns HCFA 1500 print images into HIPAA compliant electronic claims! Audits claims to over 90% accuracy to improve cash flow and reduce billing costs. Supports many provider specialties that other packages don't bill correctly. Don't wait days for acknowledgments: SolAce has them for you in minutes.
• Management Systems Consulting, Inc.
Management Systems Consulting, Inc. (MSC, Inc.) is a Professional Services Firm specializing in business systems flow management.  We support a wide variety of business systems services but are very focused on electronic business to business transactions, EDI & e-Business activities. ...MSC, Inc. is now offering our consulting skills to assist organizations with the deployment of HIPAA mandated EDI transactions.  Utilizing cross platform experience, MSC, Inc. is able to integrate the new HIPAA EDI transaction sets into the existing business transaction flow of medical benefits, claims, and payment processing.
• HIPAA Glossary
• Computer Terms (glossary)
• McKesson Information Solutions
McKesson Information Solutions is committed to helping customers successfully meet HIPAA mandates. By carefully monitoring and planning for the final regulations, we will assist customers in meeting the rigorous requirements imposed by Administrative Simplification. We will continue to update HIPAA Link with the most up-to-date HIPAA news and resources, and will provide educational opportunities via Web seminars, teleconferences and speaking engagements throughout the HIPAA implementation process.

To date, 75 percent of McKesson Information Solutions customers have installed the McKesson software releases that are enabled to meet HIPAA Transaction and Code Sets requirements. In addition, McKesson's clearinghouse, the Transaction Solutions Hub, has been certified by Claredi, a third-party HIPAA transaction certification organization, for the 835, 837 and 270/271 HIPAA transactions. For more information about the HIPAA-enabled product releases, view the HIPAA Readiness Disclosures posted on HIPAA Central.
• Medical-Coding.Net
Medical-Coding.Net brings you several data files to help you comply with the Healthcare Portability and Accountability Act requirements for standardized transaction and code sets. See our Data Files for the code sets that you need and check below for the transaction standards. All files are shipped with the official documentation from ANSI.
• Medifax EDI
Medifax EDI is a leading provider of innovative healthcare information technology solutions to providers and payers processing more than 200 million transactions per year for more than 130,000 healthcare providers. Medifax EDI is the leading provider of medical eligibility transaction services in the United States and also provides claims management solutions, practice management systems, and other financial services.
Medifax EDI HIPAA Compliance Information
Medifax EDI Pharmacy Services Division
• Mercator Inside Healthcare
Mercator Inside Healthcare™, a suite of Industry-Ready Integration Solutions™ provide rich, healthcare-specific functionality that streamlines adjudication and supports eHealth initiatives, enabling healthcare organizations to leverage tactical compliance into long-term strategic advantage. Like Mercator's other industry-ready integration solutions, Mercator Inside Healthcare™ runs on our strong and reliable integration platform, Mercator Inside Integrator™, so you get the advantage inside integration-an advantage you can count on to rapidly integrate your business-critical applications and leverage current technology investments.
Offering flexible solutions that are easy to implement and require minimal coding, Mercator Inside Healthcare™ provides connectivity, rich integration, and transformation capabilities. Prepackaged functions enhance your ability to send and receive electronic healthcare transactions, receive and transmit data using legacy standards, integrate with internal applications and data, and leverage integration investments across multiple projects.
Mercator™ supports all major healthcare standards, including HIPAA, HL7, and NCPDP, providing solutions that enable compliance, adapt to change, maximize current technology investment, and deliver strategic advantage.
• NACHA - The Electronic Payments Association
NACHA - The Electronic Payments Association is the leading organization in developing electronic solutions to improve the payments system. NACHA represents more than 12,000 financial institutions through direct memberships and a network of regional payments associations, and 650 organizations through its industry councils. NACHA develops operating rules and business practices for the Automated Clearing House (ACH) Network and for electronic payments in the areas of Internet commerce, electronic bill and invoice presentment and payment (EBPP, EIPP), e-checks, financial electronic data interchange (EDI), international payments, and electronic benefits transfer (EBT). NACHA's Mission is to promote the development of electronic solutions that improve the payments system for the benefit of its members and their customers.

NACHA is dedicated to improving the payments system through its eight primary functions. These are:
1. Rule-making for the ACH Network and other payments systems;
2. Facilitating the development of new payment applications;
3. Identification and implementation of risk management initiatives;
4. Providing and supporting education programs;
5. Instituting and monitoring quality controls in the payments system;
6. Improving member communications/relations;
7. Responding to regulatory and government relations issues; and
8. Marketing electronic payment services.
• NDEDIC - National Dental EDI Council
Mission: To unite all stakeholders in the promotion of electronic connectivity in the dental benefits industry.
Vision: Through knowledge-based leadership achieve electronic connectivity in the dental benefits industry.
NDEDIC is the only organization that unites all stakeholders in the dental benefits industry to promote electronic commerce, providing a forum for dental EDI. (Electronic Data Interchange)
We offer educational opportunities in dental EDI; we collect and provide information on dental EDI; we create and promote forums for dental EDI.
• 1 EDI Source, Inc.
1 EDI Source, Inc., was established to provide affordable EDI solutions and expert EDI advice to companies of all sizes. With an in-house staff of 35, 1 EDI Source is made up of an expert team of technicians, programmers, and consultants, all of whom work together to ensure that your EDI solution fills your needs. Now in its twelfth year of business, 1 EDI Source boasts more than 1000 clients –ranging from the independently owned, one-person operation to international corporations where reliable EDI is crucial to the operation of the business. Whatever your goal is in regard to EDI, we can help you achieve it.
HIPAA Product: Using EDI Complete-HIPAA Edition, healthcare providers can meet HIPAA requirements and, at the same time, make fundamental changes in the way they communicate and exchange information.
EDI Complete-HIPAA takes the numerous benefits contained in the EDI Complete software and tailors them to the healthcare industry. In addition to full inbound and outbound data mapping functionality, high-performance translation, and complete EDI/application systems integration, EDI Complete-HIPAA will allow you to: submit a claim for services rendered; verify a patient's eligibility and benefits; update information regarding patient coverage; obtain authorization for treatment.
• Per-Se Technologies - HIPAA
Per-Se Technologies is committed to delivering services and products that enable our clients to meet the requirements of HIPAA. Our industry knowledge, leadership and integrated internal business processes position us to help our clients address the challenges of HIPAA while meeting their long-term goals. Per-Se products and services provide a complete solution for an environment where HIPAA compliance is important and maintaining a competitive advantage is essential. Per-Se provides solutions, from clinical system to patient management to accounts receivable, that allow for an uninterrupted flow of data with secure electronic transactions.
• Private Technology Sector Group
The PS-TG serves as an advisory panel to CMS and the states on technology issues affecting the private sector and the Medicaid Management Information System (MMIS). Member companies of the PS-TG group collectively process one billion Medicaid claims per year worth more than one hundred sixty billion dollars in payments to almost one million health providers for services rendered to more than thirty million eligible recipients. At the request of PS-TAG, the PS-TG HIPAA workgroup developed a White Paper on the Pros and Cons of states using Translators versus Clearinghouses for HIPAA compliance.
• Pro EDI
Multi-user, easy to use, intuitive electronic data interchange (EDI) software for Windows, UNIX, LINUX, and HP3000. Convert your business transactions to standardized electronic files and speed them to an unlimited set of trading partners. Let our EDI solution turn your documents around in minutes instead of days. Pro_EDI EDI translation software can eliminate re-keying errors and increase data accuracy which will help to minimize trading partner charge-backs. Whether you need an EDI translator to exchange documents using the the EDI X12, EDIFACT or HIPAA EDI standard, we can support your requirements. Our EDI mapping software translator will help you to boost productivity and return on investment. Our Internet EDI services will save you a bundle on your EDI VAN costs. Sending your EDI documents over the Internet with our encrypting software is not only safe, secure and less expensive, it is also faster than traditional dial-up VAN services.
If you are looking for an EDI translator solution that supports the EDI standards, provides flexibility and won't break your budget, then you definitely need to check out our Pro_EDI software solution and Internet EDI services. You won't be disappointed!
• Quadax Medical Billing Solutions
Quadax offers a variety of data processing products and services for the United States healthcare industry. Those offerings support the gamut of size and medical specialty among care and insurance providers.
Products: HARP manages your receivables while keeping pace with the challenges of healthcare including HIPAA. Flexible, powerful, reliable and compliant. Xpeditor loads or inputs your claims, connects you to hundreds of payers, and gives you payer-specific information so more of your claims are approved the first time. Quadax's family of business services builds on our decades-long history of healthcare data processing. Quadax provides a broad array of print & mail, imaging, and data entry services for the healthcare industry.
• Rachel Foerster & Associates, LTD
Providing HIPAA, EDI, XML, electronic commerce planning, implementation & integration services to deliver total cost reductions
• Redix Healthcare Package
Redix International, Inc., incorporated in August of 1994, specializes in the development, marketing, and support of B2B, XML, EDI, DTD, Schema, HIPAA, and Electronic Commerce software. Redix International, Inc. has an HIPAA/EDI package dedicated to the HealthCare industry. This package includes the following:
1. Redix AnyToAny Format Converter Engine
2. Redix Format Converter GUI Mapper with Authoring Tools
3. HIPAA database, which incorporates all the HIPAA (Health Insurance Portability and Accountability Act) transaction sets: 270/271, 276/277, 278, 820, 834, 835, 837 (Institutional, Dental, Professional)
4. Supports Six Levels of Testing recommended by WEDI/SNIP.
5. Supports version 4010, 4020, and 4030 X12 databases
6. Supports the HIPAA syntax rules and code definitions
7. HCFA (Health Care Financing Administration) databases, which includes the NSF Version 2.0 and 3.1, and the UB92 standard Version 5.0 and 6.0
8. Pre-defined maps between the HIPAA Professional Transaction Set and the HCFA NSF standard
9. Pre-defined maps between the HIPAA Institutional Transaction Set and the HCFA UB92 standard
10. Pre-defined maps between the HIPAA 835 Transaction Set and the HCFA ERA standard
11. The proprietary UB92 format, such as the state specific Medicare/Medicaid UB92, is also mapped to a HIPAA 837 transaction set in a pre-defined map.
12. Pre-defined maps between the Interactive Eligibility Request (IHCEBI) and the HIPAA 270 Transaction Set
13. Pre-defined maps between the Interactive Eligibility Response (IHCEBR) and the HIPAA 271 Transaction Set
• Siemens Health Services - HIPAA Central
Siemens can help your health enterprise capitalize on Internet technologies and begin the process of HIPAA compliance through cost-effective services and applications - today. Site includes an overview of HIPAA basics and descriptions of Siemens' available HIPAA services.
Claredi, the nation's leader in HIPAA and compliance testing and certification, has certified Siemens' HDX®, INVISION®, MedSeries4®, NOVIUS® Home Care, NOVIUS Physician Enterprise Manager, SIGNATURE®, Total Home Care, and UNITY®.
• Stratford Software, Inc.
The Stratford EDI software is HIPAA ANSI X.12N v4010 compliant. Features: Comprehensive practice management software; EDI software formats: ANSI X.12 837/835/270/271 - as required by the HIPAA federal law - v4010; National Standard Format - will be phased out sometime after October 15, 2002 as the HIPAA law requirements are enforced by the federal government; transmit to all Medicare contractors in all states; transmit to most clearinghouses such as ProxyMed (you may be charged for claims by the clearinghouse) transmit/print medical (HCFA 1500), dental (ADA), and institutional (UB92); Format currently approved by all Medicare contractors, EDS/NHIC, NDBCBS, EDS for Medicaid HCFA 1500 and rural health: UB92, Wisconsin WPS for Medicare ambulance, and the list goes on and on. All carriers who accept electronic claims approve our format(s) or they will in the near future. Check with the individual carrier for details.
We do not require you to transmit to us or anyone else. We have no per-claim or sign-up fees related to transmitting claims. That is determined by the clearinghouse that YOU select. Note: even though we will try to help you transmit to a specific payer/clearinghouse, we have no control on their charges or requirements. Maximum number of users: no maximum built into the software. Maximum user database size: Tables may have up to 1 billion records each/up to 2 gig per table.
• ViaTrack Systems
Attention Developers: Do you need help building or testing 837 or other HIPPA-based Transaction files? If so, ViaTrack offers a range of software tools & professional services to help your system create & send HIPAA compliant files. ViaTrack specializes in providing IT developers and healthcare administrators with professional software tools and services, specifically designed for building, testing and analyzing HIPAA-based X12 data structures. Our reliable and proven systems are designed to complement your internal resources while allowing you to maintain flexibility over your testing environment.
• WebMD Envoy
From Internet solutions to point-of-service devices to fully integrated transaction processing applications, WebMD Envoy offers a full suite of products to automate key business functions in the health care reimbursement cycle. WebMD Envoy is the health care industry's leading clearinghouse for all types of batch and real-time transactions, enabling over two billion transactions each year. Whether you are a payer, a provider, or an IS vendor, WebMD Envoy is your all-payer, all-provider solution for increasing your volume of electronic transactions.
• XML Global Technologies
XML Global is certified and ready to help healthcare organizations comply with government HIPAA regulations. The XML Global HIPAA solution enables businesses to integrate HIPAA transactions both inbound; receiving an EDI HIPAA document from another organization, validating its contents, and mapping the data to virtually any database, packaged application, or back-end system, and outbound; generating valid HIPAA transactions from the same array of back-end systems. A rules engine ensures both the validity of incoming and outgoing HIPAA transactions, and that any unique business rules are followed. Added to the smooth handling of HIPAA transactions is the easy integration with a myriad of channels through which these transactions may be received - FTP, email, MQ Series, JMS, file system, SonicMQ, SOAP(Web Services), HTTP, OracleAQ, and ebXML Message Services. Or, roll your own HIPAA solution with the incorporation of an embeddable Data Transformation Engine and Java APIs.

These links were collected and organized by Hammer Logic LLC.
No warranty is stated or implied, and inclusion here does not constitute an endorsement.

Last updated August 23, 2003
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