Deborah O'Rear – Sr. Technical Consultant

In healthcare, most data is exchanged electronically between partners via EDI (Electronic Data Interchange), and “Big Data” is helping the industry become more efficient and productive. EDI originated because it provided a structured mechanism for sharing data between disparate organizations and systems. The more common means of transferring data from source to a data warehouse […]

If you are doing EDI, at one time or another you have had to troubleshoot why your data is being rejected. This article deals with just a simple error received and how to find the solution. Sometimes it is easier than you think. This particular error came as an XML message. I am only going […]

The 2010 passage of the Patient Protection and Affordable Care Act (ACA) and its Section 1104 establishes a national healthcare operating rule mandate in support of the industry’s ongoing administrative simplification efforts. The first healthcare operating rule set, issued by CMS in July 2011, mandates the adoption of CAQH CORE Operating Rules for Eligibility and […]

Take the initiative and create as thorough a testing plan as you can. Remember – test, test, test, test, and test again. I can’t stress this enough. You are now ready to start testing with your trading partner, which could include a provider, clearinghouse, another payer, etc. Do you know what needs to be tested, […]

As your grandmother used to say, “You can catch more flies with honey than with vinegar.” This is the attitude you should use when establishing rapport with your trading partners. It also works well when dealing with most situations. This doesn’t mean that you have to bend over backwards and acquiesce, but if you are […]

It is very important to make sure you determine your hardware requirements if you are implementing EDI for the first time, changing your EDI software or your EDI data needs. If you have already met your needs then you’re ahead of the game. If not, then once again make sure you get all key stakeholders […]

Choosing your clearinghouse or VAN is a very important step, especially if you are in healthcare. In healthcare you need to make sure they are HIPAA compliant, which means they will be able to handle all the mandated transaction sets. Other industries have different requirements. Whichever clearinghouse you choose, you need to make sure they […]

This is a very important step in the implementation of EDI. This step informs several of your other decisions; hardware, additional software, staffing, etc. Your previously identified data needs will also help to determine your software package. When shopping for your EDI software package, make a check list of your requirements. Here are a few […]

In the previous blog we discussed the importance of knowing your data and business requirement needs. This is one place where that becomes important. If you already know your needs it makes it much easier to start your data mapping. First you should contact your trading partner. They should have some type of functional specs […]

Hopefully everyone answered ‘yes’ and you had a smooth transition. In this blog we will discuss some of the items we need to keep in mind when either transitioning or implementing EDI. Whether you are getting ready to transition to a new standard or initiating EDI for the first time, remember the most important thing […]