Administrative Simplification
The path to compliance can lead to reduced operating costs. Administrative Simplification achieves this dual goal through Edifecs Smart Trading and Compliance. Edifecs Smart Trading automates every type of data exchange and validates data preventing failures in back-end systems. Comply with healthcare mandates using Edifecs’ comprehensive suite of HIPAA, ICD-10, Operating Rules and test products.
The Best Approach
All post-reform healthcare initiatives require compliant data exchange. Edifecs Smart Trading dramatically reduces IT infrastructure and administrative costs. The solution supports any-to-any interoperability and industry leading visibility into transactions and member activity. Our Compliance suite governs partner exchange to reduce costs and risk at every stage - planning, cross-walking code sets, testing and monitoring.Solution Overview
Administrative Simplification requires taking action to exchange data and integrate systems while ensuring that the right steps are taken to comply with industry mandates. Moving data at scale while controlling costs is a major challenge as digital health interoperability becomes a strategic imperative and mandate penalties become more severe.
Interoperability Realized
Interoperability is an industry buzzword but it has never been more important. At the foundation of every post-reform healthcare initiative is the need to connect partners and exchange clinical documents, claims, pharmaceutical usage and other administrative data. Healthcare IT infrastructure requires a framework that connects every partner, standardizes incoming data formats, controls data quality, serves correlated meaningful results to all users and integrates easily to both enterprise and start-up applications. Digital health interoperability requires a strong foundation.
Mandates Met
Edifecs Compliance delivers products and services for every phase of the compliance process from planning to implementation to testing and assessment. Industry leading ICD-10 coding products and services provide clinically sound cross-walks and maps and comprehensive testing and analytics to quantify risk and impact. The Operating Rules suite streamlines data exchange, monitors service level agreements and reduces the risk of penalties. Edifecs operates the free CORE Certification Testing Platform to enable CAQH certification.
Plan. Build. Run. Get Help.
Edifecs provides assistance at every stage. Is a health check needed to build a business case for investment? Edifecs Strategic Advisory Services provides fast response: understand the business impact, technical issues and the needed steps to fill the gaps. Are implementation services required? Are clinically trained coding consultants needed to extend the core team and expedite completion? Interested in hosting services or cloud options? Edifecs Professional Services has the expertise and knowledge to deliver on time and on budget.
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