TransSend allows Healthcare organizations to leverage their investment in HIPAA while increasing the level of HIPAA commerce through the rapid deployment of a cost effective solution which reduces administrative cost while simultaneously increasing trading partner satisfaction.
The TransSend architecture isolates the client back end system and provides a “wrap around” solution to conduct business in a HIPAA fashion. This approach provides Clients with a high degree of flexibility in meeting current needs while providing an architecture which can accommodate future changes or migrations with minimal impact.
Features and Functions of TransSend include:
- Perform front end business validations (277CA)
- Provides batch management
- Supports transaction change audits
- Allows for user exception processing
Real Time Processing
- Custom lookup processes
- Web Services
- 27x series transaction support
Validation, Workflow and Transaction Routing
- Provides level 1 thru 7 compliance validation via TIBCO’s Foresight In-stream compliance product which is OEM’ed within TransSend
- Manages file transfer and archival
- Security and Logging
- Customizable flows
- Web Based
- DDE or file based leveraging our SolAce EMC product
- Clean claim business edits and compliance edits
- See transactions as business documents in browser
- Support for web services searches
- Full support for EDI operations area
Encounter Processing and Reconciliation
- Identify HIPAA Compliance errors before encounters are sent to the receiving entity
- Identify errors (business edits) before they are sent to the entity
- Identify possible duplicate encounters which have been sent previously
- Send only good transactions to the receiving entity
- Report successful receipt of the file by the receiving entity (997/999)
- Perform transaction level matching utilizing response claim status acknowledgements (277CA)
- Perform transaction level matching (Adjudication) of proprietary business edits from CMS and Medicaid to identify errors which need to be corrected.
- Track the status of each file and individual claim.
- Provide users the opportunity to annotate and then report on those claims which need to be corrected in either the adjudication systems for resubmission or the EDI creation process.
- Creates Reports on the percentage of acceptance of submissions for senior management
- Provides management level process overview information
TransSend supports all of an organization’s HIPAA transactions and conforms to the mandates outlined in the CAQH CORE Operating Rules. Transactions are processed by a workflow component that manages all front end processes including Trading Partner Validation, customizable HIPAA Compliance checking, archiving, error reporting, removal of non- compliant transactions from a file, and many other functions. Transactions (including all data elements) are immediately available for searching and viewing via standard customizable browser screens, and standard soap based web services. Claim transactions (837) Enrollment transactions (834) and 820 transactions are supported by a distinct Payer Processing Module that allows staff to monitor the status of batches of transactions, work individual exceptions and view original submitted EDI browser based business reports.
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