Key Features
The Edifecs Transaction Management solution includes the following key system features.
Transaction Monitoring
Edifecs Transaction Management includes a set of pre-defined dashboards for monitoring throughput rates, end-to-end
latency, error rates and other key performance indicators. In addition, enterprises can define their own measures
to be tracked based on their specific business needs.
Notifications and Alerts
Automatically send notifications to relevant users when specific actionable events occur in Edifecs Transaction Management.
For example, a business user may wish to configure a business rule that distributes an alert to the appropriate parties
when a threshold dollar amount for any set of transactions exceeds a predefined level.
Transaction Search and Business Views
Edifecs Transaction Management includes a rich web interface for finding transmissions, claims, and other
transactions. Users can drill down and view transaction data in a formatted business-friendly view that contains
links to processing events, response transactions, as well as the source data. Transaction data is indexed for
security so that even a billing provider that has submitted a claim through a clearinghouse that aggregates for
multiple providers can log on and access just their piece of the overall transmission.
Reporting
Edifecs Transaction Management provides a set of well-defined healthcare-focused reports, as well as rich ad hoc
reporting capabilities that provide the information you need to make better business decisions. Rapidly
tailor reports to display transaction and processing data grouped, sorted, filtered, and charted as required.
Define summary calculations such as totals and counts, and perform trending and other analysis. Reports are
available as HTML, and can also be exported in CSV and MS Excel formats. Each report can be run and
distributed automatically based on a schedule and per your required business rules.
Transaction Reconciliation and Response Documents
Edifecs Transaction Management comes with a set of reconciliation rules for linking the 270 and 271 eligibility
transactions, the 276 and 277 status transactions, the 835 and 837 claim and payment transactions, and the
837 and 277 transactions as well as others. The reconciliation features also track 997 and TA1 acknowledgements
in response to inbound submissions. Inquiry and response transactions may also be linked to individual claim
files and their acknowledgements, for end-to-end tracking.
Event Tracking
Edifecs Transaction Management’s event tracking features allow for the tracking of events across the entire
transaction lifecycle. Event consumers, which can listen for events being raised by your existing solution components,
are provided out-of-the-box for the IBM Common Event Infrastructure (CEI) Events and for Java Messaging Services (JMS)
or can be easily written using a provided SDK.
Unified Trading Partner Management
Edifecs Transaction Management’s trading partner management features provide for a rich, customizable repository
that can accommodate a wide variety of information such as contacts, attachments, and profile information. The
trading partner database supports the definition of business roles, role-specific identifiers, and wizard-driven
schema definition. The partner database can be loaded through a data import wizard, through self-registration by
your partners, through an online administrator wizard, and by auto-extracting partner information directly from
your healthcare EDI transaction files.
File Submission and Retrieval over the Web
The web submission features are designed to enable smaller trading partners to upload 837 claims files, 834
enrollment files, and other transactions securely over the internet using their web browser. This alleviates
the need to use a clearinghouse or more complex connectivity software and provides the benefit of immediate
feedback as to whether the file is valid or requires error correction before it can be adjudicated.
Healthcare Transaction Repository
Edifecs Transaction Management includes the Edifecs Healthcare Transaction Repository (HTR). ETL technology
extracts, transforms and loads EDI-formatted data into a business-normalized repository. The Repository
stores and audits the transactions, including error results, key indexes and metrics. It also stores related
events or other transaction information that has been raised through its APIs, such as events from the IBM Common
Event Infrastructure.
Transaction Validation and Acknowledgements
Edifecs Transaction Management includes the Edifecs XEngine validation engine which takes transactions from
your existing middleware infrastructure, validates them, splits them, routes the resulting transaction
bundles, and creates any necessary acknowledgements. XEngine provides validation for WEDI SNIP Types 1 to
7 and creates 997, TA1 and 824 and other acknowledgements. Errors are loaded into the transaction repository
to facilitate analysis and troubleshooting.
Scalability and Performance
Edifecs Transaction Management has been designed to process millions of transactions a day with configuration
options available to customize what is tracked and how long it is stored.  |
