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SIMPLIFIED MANUAL INTERVENTIONS IN HEALTHCARE EDI

Cost-effective HIPAA compliant X12 schema validating tool, SimplyEDI helps business users in health insurance industry to simplify manual interventions in complex Electronic Data Interchange (EDI) transactions to significantly reduce costs and improve customer net promoter score. It is primarily used in Claims Adjudication, Billing Reconciliation and Enrollment Inquiry. The business users can not only view the files in a human-readable format but can also create, edit, validate and reprocess them as required. SimplyEDI offers a user-friendly UI with a built-in parser and validator to validate the EDI files against the respective specifications. Time spent on manual interventions can be reduced by 80%-90% with SimplyEDI.

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Supported Formats

SimplyEDI supports multiple EDI ASC X12 file formats used in the healthcare insurance domain such as:

  • 820 Premium Payments
  • 834 Benefit Enrollment and Maintenance
  • 835 Health Care Claim Payment/Advice
  • 837P Professional Health Care Claim
  • 277 Health Care Information Status Notification Transaction Set
  • 276 Health Care Claim Status Request
  • 278 Health Care Services Review Information
  • 270 Eligibility, Coverage or Benefit Inquiry
  • 271 Eligibility, Coverage or Benefit Information

SimplyEDI has been architected on an open and extendible framework that can be easily configured to support many more EDI file formats that are used in various industries beyond healthcare.


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