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:
Transaction Processing
- 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
- Acknowledgements
Claims Creation
- Web Based
- DDE or file based leveraging our SolAce EMC product
- Clean claim business edits and compliance edits
Portal
- 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.
WHY YOU SHOULD CHOOSE TransSend
Meet all of your HIPAA transaction requirements with one application
Yes, all of them! TransSend supports all transaction requirements and all of the complex business scenarios needed to import transactions, get them into your back-end systems, and generate all of the required response transactions and acknowledgements without needing to purchase a translator or a compliance checker.
Demystify HIPAA EDI and improve provider and employer group support
Stop paying people to tell you what your EDI says. All EDI transactions are viewable as business documents in the TransSend Portal. DTP segments are dates and NM109 fields are names. Claims, enrollment, and customer service staff become empowered to understand and answer EDI related questions.
Ready to support operating rule requirements today
TransSend is already currently deployed at many plans supporting CAQH CORE II mandated Real Time Eligibility and Claim Checking Requirements (270/271, 276/277).
A proven product and an exceptional support and development team
TransSend is deployed at some of the most sophisticated organizations in the country, supporting mission critical business operations. TransSend processes over 30 million claim transactions a year including inbound claims, outbound encounters, and generates and receives repriced claims. Check out our use cases for some examples of what we do for our Clients, or contact our sales team for more information.
Flexibility and total cost of ownership
For most of our Clients, the 5010 migration was a non-event. How many Health Plans can say that? Is your claim system vendor changing their claim load format? With a simple call or email, there is good chance we can implement it in a day or two. Want to reject a claim in a 277CA because of a newly discovered claim system bug? Consider it done. Implementing a whole new back-end system while re-engineering every moving piece of your organization? We have seen it before. Once you have implemented TransSend, our staff is expert at configuring and customizing it to keep you one step ahead of the next set of initiatives. Check our references and let the AXIOM team be the Gold Standard you will use to evaluate your other vendors against.
More Details About TransSend
