Overview

Healthcare is undergoing one of the biggest changes in administration that the industry has seen in many years. In this time of increasing financial, operational and regulatory pressures on health plans and payers, executives are discovering that electronic healthcare transactions present as many challenges as they do opportunities.

Increases in volumes of these transactions offer a tremendous opportunity to decrease the costs of handling paper submissions. However, when coupled with the cost and complexity of ramping up trading partners, the net benefit may be difficult to realize without a robust process to manage these additional layers of complexity.

Additionally, many have found that the failure to provide a rich testing process can cause auto-adjudication rates to go down, not up, which is contrary to the objective of HIPAA Administrative Simplification — creating unintended costs and negative impacts for payers, providers and consumers.

Challenges Faced by the Healthcare Industry

• Many healthcare organizations are faced with ramping up hundreds or even thousands of new submitters to send HIPAA, HL7, NCPDP, XML and other electronic documents.
• Testing and production environments are not totally in sync, nor are they highly predictive of trading partner success.
• Many trading partners are not HIPAA-compliant, or compliant with your specific business data requirements.
• Testing has become a highly manual, complicated and expensive proposition.
• The quality of data files continues to be an issue for production.
• Targets, resources, and deadlines simply do not add up.
• Current solutions are not flexible, and do not allow easy management of HIPAA edits, companion guide edits and business edits at all levels in a way that ensures compliance and transaction throughput.

Edifecs Ramp Management for Healthcare

End-to-End On-Boarding and Testing That Mirrors Your Production Environment

Edifecs, the leading provider of B2B solutions for transaction-based interoperability, addresses all of these challenges with Edifecs Ramp Management, the market-leading solution for enabling new trading partners. Edifecs Ramp Management ensures functional interoperability with trading partners by allowing you to quickly ramp them up and test with them through all of your business scenarios, as well as effectively manage them in the face of changing standards and requirements.

Edifecs Ramp Management automates the testing and implementation process, reducing the time and resources required for achieving healthcare transaction interoperability with your trading partner community. Edifecs Ramp Management is the most widely-deployed community enablement solution on the market today, with dozens of successful private and public healthcare organizations realizing tremendous operational efficiencies, all while increasing transaction throughput for their trading partners.

Available standalone or as an integrated component in the Edifecs Healthcare Suite, with Edifecs Ramp Management you can:

• Accelerate the trading partner enablement process to shorten the lead time to production and achieve a faster ROI.
• Take the headache and expense out of testing, reducing the risk of production errors by allowing partners to self-test, at no cost to them.
• Mirror your true production environment by defining and effectively managing the different testing scenarios and specific data requirements for your physicians, hospitals, chiropractors, and other categories of submitters.
• Test all seven types of edits described in the WEDI/SNIP Testing White Paper including your own custom edits (Companion Guide edits).
• Simplify community management and support through issues tracking, notifications and alerts, online document repository and surveys.
• Create a complete view of your trading partner community using reports and dashboards to understand and document your current status as well as future trends.