HealthCare EDI
Whether it's inaccurate insurance information or the challenges of consumer-driven and high deductible health plans,
when it comes to timely reimbursement, physician offices face a wall of obstacles and paperwork.
That's why GeniusDoc EHR has created a system that helps catch errors up front while streamlining the
claims payment process. By processing claims and payments at the point of care, GeniusDoc can help your practice
take control of account receivables, reduce administrative costs, claims re-submissions and rejected claims,
and ultimately speed payment.
What is EDI?
Electronic Data Interchange (EDI) is the transmission of data (medical insurance claims, for instance) from computer to computer,
instead of printing to paper and mailing.
EDI offers some spectacular advantages over paper requiring minimal human intervention that are described below.
GeniusDoc Partners with Gateway EDI to Simplify Your Life and Increase Your Bottomline
Recognizing that Gateway EDI has become one of the nation's fastest growing health care EDI providers,
GeniusDoc EHR provides Gateway EDI services to providers enrolled in contracted health care plans.
Transactions are accepted electronically into our system and are processed through the Gateway Clearinghouse.
As a Gateway EDI service, we provide connectivity to various health care plans and states where Gateway EDI is
the fiscal agent, third-party administrator, or contracted clearinghouse.
Why Gateway EDI?
Offers Simple Solutions to Complex Business Electronic Connectivity Challenges
Electronic Healthcare Network Accreditation Commission Full Accreditation:
- For Meeting Quality Performance Criteria for Quality Performance in Five Areas
- Privacy and confidentiality
- Technical performance
- Business practices
- Resources
- Data security
High Performance Standards for Standard Claims Processing and Status Reporting:
- Routinely answer 98 percent of all customer service calls in person with 92 percent instant resolution
- HIPAA compliant solutions
Using GeniusDoc, Gateway EDI's Electronic Transactions Acquisition Services Provide an Array of Tools that Allow You to:
- Easily submit all of your transactions to one source
- Submit transactions twenty-four hours a day, seven days a week
- Receive confirmation of receipt of each file transferred
- Receive remittance notification from health care plans on a regular basis
Advantages of Gateway EDI
- Submit to Over 3,000 Payers Across the Country
- Quick Turn Around Process
- Rewards its providers for "good behavior" with the "99 Percent Club"
- Voluntary membership to those who submit claims in a Gateway EDI specific format and timeframe. Any Gateway
EDI provider that:
- Files claims in less than 15 days from the service date
- Produces more than 200 claims per month
- Maintains an overall claim acceptance rate of 99 percent
- If a member meets these standards, Gateway EDI commits to file their claims in as little as two days.
- This translates into:
- Quicker resolution of rejected claims
- Enhanced cash flow
- Revenue from otherwise lost claims
- Eliminating resubmission costs
- Decreased accounts receivable by at least 5 days
- Overall administrative efficiency
- Few claims clearinghouses today are willing to commit to or succeed in this quick turn-around process
- Reduces Overall Error Rate
- Gateway EDI customers have lowered their average overall error rate to only 7 percent!
- Secondary Claim Processing
- Gateway EDI is the industry's ONLY all-electronic solution for secondary claim processing
- How it works:
- Gateway EDI electronically reads the primary claim payment to evaluate existing patient coverage
- If a supplemental policy exists, but there has been no action taken, Gateway EDI will
- Manage that claim by switching the flag in the file to reflect filing of that claim
- Send the modified 835 to the provider
- File a clean supplemental claim along with appropriate documentation
- Process the secondary both electronically and via paper
- Work with a variety of commercial insurers, Medicare, and Medicaid
- Helps providers recoup ignored & lost claims