I think his "clearing house for insurance billing" is a third party adjudicator. And he wants to know how to do EDI without an translator or knowledge investment.
If someone knows of a service bureau that does HIPAA specific documents, this guy needs you! Brian Lehrhoff, EA ([email protected]) Messaging Consultant 201-913-4506 Upgrade your Quickbooks for 20% off at http://ea.brianlehrhoff.com Circular 230 Notice is located at http://ea.brianlehrhoff.com/230notice.html ________________________________ From: Michael Mattias/LS <[email protected]> To: [email protected] Sent: Monday, February 13, 2012 4:42 PM Subject: Re: [EDI-L] EDI 837 to a clearing house >I have been tasked with creating a small application to capture medical >billing information and store that in a database and then >after the client codes it > I need to send it to a clearing house for insurance billing. I have hard > coded it to send 837 to clearing house however I would > be more comfortable with a > package solution. it needs to be inexpensive but we only need to process > medical insurance billing to a clearing house and > receive remits from the same. Um, the purpose of clearinghouses is (should be?) converting your proprietary format data to the required ANSI ASC X12 format for transmission to the payer. If you are generating the '837' you don't need to pay a clearinghouse for anything. Methinks I am missing part of the puzzle here; or maybe we are not using 'clearinghouse' to mean the same thing... unless maybe you are sending some consolidated file containing multiple interchanges (or just transaction sets?) and the clearinghouse is splitting those by payer, enveloping and handling the communications(???) If it's the "split, enveloper and communicate" scenario, any decent VAN can handle that, you should not require a 'specialty house' If you are worried about the ANSI data you are generating, that's another issue. I'm not sure you are going to find a real good "canned" piece of software do that, except in one of the "EDI packages" which does mapping, too; but if you can code to create an 837 I am absolutely certain you can use a mapping tool to replace that code. And since you brought it up, if you want low cost remittance processing ==-> http://www.providerpaymentpartner.com. 10+years on the market, upgraded early 2011 to handle the X221 (005010 based) remittance format in addition to the X091 (004010-based) standard. Still less than $500.00. Michael C. Mattias Tal Systems Inc. Racine WI [email protected] ------------------------------------ ... Please use the following Message Identifiers as your subject prefix: <SALES>, <JOBS>, <LIST>, <TECH>, <MISC>, <EVENT>, <OFF-TOPIC> Job postings are welcome, but for job postings or requests for work: <JOBS> IS REQUIRED in the subject line as a prefix.Yahoo! Groups Links [Non-text portions of this message have been removed] ------------------------------------ ... Please use the following Message Identifiers as your subject prefix: <SALES>, <JOBS>, <LIST>, <TECH>, <MISC>, <EVENT>, <OFF-TOPIC> Job postings are welcome, but for job postings or requests for work: <JOBS> IS REQUIRED in the subject line as a prefix.Yahoo! Groups Links <*> To visit your group on the web, go to: http://groups.yahoo.com/group/EDI-L/ <*> Your email settings: Individual Email | Traditional <*> To change settings online go to: http://groups.yahoo.com/group/EDI-L/join (Yahoo! ID required) <*> To change settings via email: [email protected] [email protected] <*> To unsubscribe from this group, send an email to: [email protected] <*> Your use of Yahoo! Groups is subject to: http://docs.yahoo.com/info/terms/
