Partnership improves quality, timeliness and reconciliation of the
marketplaces EDI transactions
BELLEVUE, Wash.(BUSINESS WIRE)
Edifecs, a globalhealth
information technologysolutions company, announced a strategic
partnership with the Washington Health Benefit Exchange (WAHBE). The
state-run marketplace implemented the Edifecs
Health Insurance Exchange (HIX) Integration Solution to
improve the exchange of electronic data between the Washington
Healthplanfinder and participating Qualified Health Plans (QHP). The
streamlined electronic data interchange (EDI) simplified the process for
plans to participate in the exchange and ensured that consumers in
Washington State were offered many plans to choose from.
For QHPs, Edifecs technology enabled standard interfaces and
accelerated participation in the state-based exchange marketplace with
condensed go-to-market times and lowered cost. WAHBE now has the ability
to proactively and quickly resolve issues between the exchange and
consumer transactions in real time, eliminating future challenges that
could impact exchange operation and access during enrollment season.
The Edifecs HIX Integration Solution transitioned EDI management from
custom-developed applications. In addition to ensuring compliance with
Center for Medicare and Medicaid Services (CMS) reporting requirements
and WAHBE standards, the integration of Edifecs technology improved the
quality and error processing of enrollment transactions and eliminated
payment data errors.
We are thrilled at what we have accomplished working with the Edifecs
team of engineers and experts, said Chris Johnson, Associate IT
Director at WAHBE. The WAHBE is committed to giving the people of
Washington a streamlined enrollment experience and Edifecs technology
has enabled our team to operate more efficiently, and to transmit and
receive consumer enrollment data both accurately and quickly.
The program was fully deployed for the 2016 open enrollment period. The
project was funded through a CMS grant.
Washington is one of the more progressive states in response to health
reform. This partnership helped ensure that WAHBE maintains is
leadership among the state-run exchange and continues to improve on the
experience, said Sunny Singh, CEO of Edifecs. In retail-based
healthcare, it is critical that exchange disruptions are minimal and
enrollment is standardized, our work with WAHBE has enabled seamless
transactions and automated processing.
WAHBE was the first of two Edifecs state-based marketplace customers.
Edifecs also provides enrollment technology solutions to many commercial
plans and CMS. The Edifecs HIX Integration Solution enables state
exchanges to consolidate critical functionality into a specialized EDI
transaction processing platform. The goal is twofold: First to improve
the quality, timeliness, and reconciliation of EDI transactions; and
second to provide new standards and formats for improving
issuer-automated processing at a lower total cost.
innovative, cost-cutting information technology solutions to transform
the global healthcare marketplace. Since 1996, Edifecs technology has
helped healthcare providers, insurers, pharmacy benefit management
companies and other trading partners trim waste, reduce costs and
increase revenues. More than 350 healthcare customers today use Edifecs
solutions to simplify and unify financial and clinical transactions. In
addition, Edifecs develops supply chain management solutions to support
worldwide customers in non-healthcare industry segments. Edifecs is
based in Bellevue, WA, with operations internationally. Learn more about
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Janet Hohmann, 415-240-6904