Even before the Healthcare Insurance Portability and Accountability Act (HIPAA), healthcare business technology required high standards for security and organization. Each healthcare provider maintained an internal system, but the lack of standardization meant that processes could vary widely throughout the industry.
This all changed with HIPAA, which took the procedures recommended in 1993 in the Workgroup for Electronic Data Interchange (WEDI) and made them required processes for all healthcare facilities. Today, healthcare EDI standards are not merely a suggestion, but a necessity for any healthcare provider hoping to maintain licensing. BizTalk Adapters facilitate healthcare automation, making these standards much easier to achieve.
A Brief Overview of Healthcare Business Technology
It would be difficult to find an office of any kind, large or small, that does not use some sort of internal database. In the case of healthcare providers, these are called Practice Management Systems (PMS).
Facilities use these healthcare automation systems to store patient records as well as billing information, so that medical histories, diagnoses, invoices and other relevant documents can be generated quickly and accurately. The greatest benefit is that when all of this information is connected, healthcare staff can work more efficiently and doctors can monitor every aspect of patient care.
Essential Tools for Meeting Healthcare EDI Standards
An effective PMS speaks two languages: the internal language of your facility and the consistent language of the healthcare EDI standards established through HIPAA.
It can interpret your records and invoices in a way that insurance companies will understand.
More importantly, the best PMS for your office ensures that your healthcare automation is fully integrated. In the days before EDI, records were exported from one format and imported into another manually, usually by office staff. Today, technology like application program interfaces and mapping simplifies the process immensely. In most cases, integration happens in the background automatically, requiring few if any steps on the part of office staff.
Once healthcare automation is handled at the office level, the resulting invoice must be transmitted to the insurance company or other entity responsible for the bill. Luckily, the most recent developments in healthcare business technology have made the previous method of sending individual invoices to insurers nearly obsolete.
Now, clearinghouses exist that work on behalf of both medical offices and insurers, offering online interfaces to connect the two. Rather than paper systems that consume an unnecessary amount of time and resources, medical staff can now transmit invoice information securely through online interfaces.
Innovative Architects can help you streamline your healthcare business technology, freeing up your staff to focus more time on patient care. To learn more about the healthcare automation services we offer, contact us for a consultation.