ClaimsBridge® maintains multiple two-way EDI connections to major clearinghouse services in addition to supporting direct connections to our clients.
Multiple Claim Formats
ClaimsBridge accepts claims from, and transmit claims to, each entity in the claim format preferred by that entity. We support ANSI standard 837s (4010/5010) as well as proprietary formats for HCFA, UB and Dental. Our most common HIPAA transaction sets are 837s, 835s and 277s.
Each claim is fully integrated with all information associated with it in ClaimsBridge. Using the ClaimsBridge Web Portal to view a claim, you can easily see claim tracking/status information, source image (if available), payment, provider and employee eligibility information.
ClaimsBridge uses intelligent, rules-based processing using the business rules for each client. Business rules are set up for new clients and updated when necessary. Every claim is processed individually, not in batches, and progresses at its own pace. Claims which needexception management do not impact or slow down other claims but are immediately flagged for attention by the appropriate party.
ClaimsBridge uses industry standard FTP, Secure FTP and PGP protocols to protect the data. Clients access the ClaimsBridge Web Portal using SSL secured connections. role-based security controls access to individual claims and associated data.
ClaimsBridge provides its payer and TPA clients with an interface to the National Coordination of Benefits Contractor (COBC). This interface provides fast and efficient coordination of benefits for Medicare supplemental claims. Through this eligibility based process, Medicare automatically forwards medical claims for enrolled members with coordination of benefits information to secondary payers.
Support for virtually all EDI claim formats, standard or proprietary
Rapid, accurate and secure transmission of claims
Claim receipts are acknowledged to sender with timestamp
Significant percent of claims are routed for payment within 48 hours of receipt
Significant improvement in claim turn-around-time
Cost effective HIPAA EDI transaction compliance for legacy systems