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EDI-INT from the Healthcare Perspective

While rising healthcare costs can be attributed to many factors, administrative inefficiencies—both internal and external—account for a sizable portion of the increase. Whether you're an insurance company, hospital, physician or supplier, you can cut significant costs by exchanging transactions electronically.

Internet EDI is designed to help organizations reduce operational costs and meet the Health Insurance Portability and Accountability Act (HIPAA) transaction and security regulations by enabling the secure exchange of claim transactions between partners across the Internet. It also serves as an interfacing engine, providing centralized administration of all healthcare applications (e.g., claims, procurement, clinical).

The result? Timely, accurate information delivered to all parties at dramatically reduced cost.

No matter what data format or application you or your partners use, Internet EDI makes communication swift and seamless, with built-in support for:

  • HIPAA
  • HL7
  • XML
  • ANSI X12 EDI
  • ASCII
  • Non-standard proprietary data
  • Integration with ERP, clinical, accounting and other systems

Healthcare industry standards

HIPAA
HIPAA is a mandated government regulation that covers privacy, security and electronic transaction standards for healthcare information. The goal of HIPAA is to dramatically decrease administrative costs through the standardized, electronic transmission of healthcare transactions, while ensuring data security and patient privacy.

More information on HIPAA:
US Dept. of Health & Human Services
HIPAA Advisory
HIPAA.org

For more information on the secure exchange of healthcare-related documents via AS2 and ebXML:
http://www.drummondgroup.com/html-v2/faq-hipaa-as2.html
http://www.drummondgroup.com/html-v2/faq-hipaa-ebxml.html

HL7
Health Level Seven (HL7) is a healthcare standards organization aimed at streamlining the exchange, management and integration of data in the healthcare industry. HL7 was formed 15 years ago to develop protocols for interface requirements of the entire healthcare organization, not just a particular department. More information.

HL7 is the workhorse of electronic data exchange in the clinical domain and arguably the most widely implemented standard for healthcare in the world.

Here is a quick checklist when researching a Healthcare messaging and connectivity solution:

  • Fast path to HIPAA transaction compliance
  • Centralized administration of internal applications (claims, accounting, clinical, etc.)
  • Built-in support for multiple data formats (HL7, ANSI X12, EDIFACT, XML)
  • Tiered solution for participation by even your smallest partners
  • Transaction tracking with audit trail
  • Secure document exchange (AS1, AS2, AS3, ebXML, PGP, S/MIME, SSL)
  • Many-to-many partner interactions enable one-step communication with multiple parties
  • Concurrent support for EDI and XML
  • Legacy system integration (Admission/Discharge/Transfer, clinical, ERP, etc.)
  • Out-of-the-box, "no footprint" web interface for file upload/download by your smallest business partners

 

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