Trust your compliance to a rock-solid industry leader
Reduce the risk of production non-compliance
Built directly on the CORE certification testing scenarios, our solution identifies implementation gaps by modeling the variation in production system load. It analyzes test results and provides dashboards to identify implementation gaps that require remediation and highlight areas to research.
Reduce cost and time to implement Operating Rules transactions and achieve compliance
For successful testing and implementation, Operating Rules must span a wide spectrum of technical and business centric requirements. Edifecs offers a scalable solution that includes HIPAA and CORE validation, and an orchestration engine to manage out-of-the-box transaction workflows for Operating Rules phases I, II and III transactions. Edifecs is a CORE compliant connectivity solution.
Track and Manage Operating Rules compliance
The Edifecs solution includes out-of-the-box dashboards and reports to comprehensively track compliance measures, and when needed, research the root cause of non-compliance issues. The product supports full integration with existing transaction workflows. Using this tool, health plans can confidently access and validate compliance measures across the mandate requirements and business lines.
Edifecs offers a suite of capabilities to identify gaps in implementing different phases of Operating Rules and recommend remediation steps. Our team offers services to assist you prepare:
Operating Rules requires wide range of technical and business centric capabilities for successful implementation and compliance. These capabilities include:
Edifecs Extended Testing Solution orchestrates a production-like trading partner interaction to enable you to:
Transaction volume and information exchange is continuing to grow rapidly and is predicted to do so through 2020. Will your infrastructure support increasing volume, multiple transaction types and protocols while remaining compliant with mandated service levels? Edifecs offers production monitoring capabilities to maintain compliance and ensure on-going compliance as new programs come on-line. The solution: