InfiniMed, Inc.

We've enhanced the EDI toolkit in exciting ways!

 

The toolkit not only maps data but can help you understand how the X.12 data got from there to here.

We implement the toolkit and transactions, upgrade from one version to the next, and enhance & customize the toolkit to meet you business processes. Implementation of any and all steps of SDLC: investigation, analysis, design, implementation and maintenance.

Collaboration at every level

  • IT heads during the full SDLC life cycle. We support the project with clear communication on scope definition direction, project progress, and issues escalation
  • Project Managers to keep the project on time and on budget. Report progress, raise issues that will impact the project
  • Trading partners to create Implementation guides (IG).
  • End users to glean business logic and "what is in their heads"for EDI implementation
  • Analysts to assist and apply business processes to the toolkit functionality
  • Programmers to implement specific business processes
  • Testers for unit and business testing and data validation
  • GE engineers and support for issue resolution and process improvement

Some useful toolkit enhancements
& customizations we've done...

  • Action codes to "Go to" runs, individual transactions such as claims, referrals, and members.
  • Custom screens/pages to show all steps used to match HMOs, groups, patients, enrollment, claims, referrals, and providers
  • Custom matching logic for HMOs, groups, providers, vendors, patients, members, claims, referrals, transactions, etc...
  • Override fields on edit screens to be able to correct incomplete data
  • Cross application logic
  • Custom rulebanks to allow users to support frequent changes without programmer intervention
  • Dictionary lookups for specific values, fields, active entries, defaults, etc.
  • Custom error reporting
  • Custom testing tools to dump filed objects( i.e. claims, referrals, enrollment records, etc.)
  • Mapping X.12 data to the database
  • Inquiry/Edits screens
  • Rulebanks
  • Implementation of specific business logic
  • Training IS staff to understand the format and how the data gets to your database
  • Reporting
  • TA1, and 997 transactions

 

Toolkit transactions we've implemented

We've implemented every transaction that GE has developed. In some cases, we've even helped GE with the development effort

  • 837/835: Claims/Remits (BAR, MCA, HPA)
  • 834: Enrollment roster (MCA)
  • 270/271: Real time interactive eligibility (MCA)
  • 270/271: Batch mode eligilibility (MCA Hold file)
  • 278: Referral and authorizations (MCA Payor Request & Provider Response)
  • 276/277: Claim status/response (MCA)
  • Up Conversion from 3051 to 4010
  • 4010, IDX Flowcast and the newest transaction sets supported
For inquiries - please contact us at (978) 646-9281 or email sales@infinimed.com.
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