IPAA promised healthcare providers a world where the whole claims submission process would be standardized and simplified.  HIPAA X12 Transactions did set a file format standard for claims and responses.  It didn’t specify a transport.  As a result, a provider dealing with hundreds of payors is faced with implementing and maintaining hundreds of different unique interfaces.  Hilgraeve has introduced field-proven technology that solves this problem.  With the HyperSend X12 Gateway, providers have one simple standard interface that they can use to connect with all their existing payors.  This gateway also includes a standardized level of tracking and reporting which significantly simplifies the whole process of claims management.

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How Does It Work?

Hilgraeve’s HyperSend X12 Gateway is based on HyperSend, Hilgraeve’s secure Internet messaging and file exchange service.  Hilgraeve’s Professional Services group will create an automated interface to your existing claims processing system leveraging your existing payor identification system.  Using HyperSend’s ability to send file securely through the Internet, claims for a particular payor will flow from your data center to the HyperSend server where they will be handed off to the HyperSend X12 Gateway.  The gateway will make the appropriate connection the payor, deliver the claim, and log the activity.  When the payor generates a response, the HyperSend X12 Gateway picks up that response, logs it, determine what claim generated that response, and delivers the file securely back to you.  Think of this as your own private clearinghouse at a fraction of the cost.

Will It Work for Me and My Payors?

The HyperSend X12 Gateway already supports those payors that process the vast majority of electronic claims.  But adding a new payor is a simple matter for the Hilgraeve Professional Services group and often can be completed within a few days of receiving the request.  The HyperSend X12 Gateway can support virtually any existing payor interface from simple FTP/PGP servers to XML, HTTPS, and even proprietary clients like Valicert, Cyclone, and Diogenes.  The HyperSend X12 Gateway can even automate claims submission to web pages set up only for manual use.  Setting up a new payor from your point of view is a simple matter of setting up a new HyperSend account for that payor and adding that account to your existing claims processing system interface. 

The HyperSend X12 Gateway can support multiple business units, submissions from multiple locations, and virtually any naming or file parsing process you can imagine – all for the same low price per Mb. 

Designed for Easy Deployment

The HyperSend X12 Gateway eliminates the need for your IT department to re-invent the wheel.  With one simple interface you can begin exchanging claims with all of the payors that Hilgraeve already supports.  Adding interfaces for new payors is a simple process that can be accomplished in days rather than months.  This same simple interface is available to all the business units in your enterprise whether accounting is centralized or distributed.

Delivers better Monitoring, Tracking, and Reporting

The HyperSend X12 Gateway not only tracks every claim sent and every response received, but it also associates responses with claims.  All of this is available in a self-service web interface that anyone in your organization with proper authorization, can view and download.  This same data can be automatically delivered securely to payor or provider specific distribution lists you create with frequencies you specify.

The HyperSend X12 Gateway also monitors activity and can generate alerts via e-mail or pager when performance falls outside predicted norms or unexpected errors occur.  This eliminates those time consuming fire drills associated with a payors failure to generate a response to a particular claim, or a breakdown in the claims submission process.  Claims processing systems that rely primarily on open-loop manual communications processes to catch errors expend a lot of time and money tracking errors.  The HyperSend X12 Gateway proactively notifies the appropriate people when a process fails to perform as expected and has all of the vital tracking information needed to quickly identify the source of the problem. 

Proven Technology from an Industry Leader

Hilgraeve, Inc. is a leading developer of communications software.  Every copy of Windows contains a program that Hilgraeve wrote for Microsoft, called HyperTerminal.  Hilgraeve specializes in secure data transfer software for the healthcare industry.  Its HyperSend technology has been embraced by leading clinical laboratories, regional laboratories, and hospital outreach programs for automating delivery and printing of lab reports, and exchanging protected healthcare information securely through the Internet.

Contact Hilgraeve today for more information.