HIPAA EDI Consulting


Wow, where do we start?  This is where it all began for DoRight Solutions, Inc.  The bottom line is simply this, if it's related to HIPAA X12N EDI then we can help!




Transaction Set Description
269 Health Care Benefit Coordination Verification
270 Eligibility, Coverage or Benefit Inquiry
271 Eligibility, Coverage or Benefit
274 Health Care Provider Information
275 Patient Information
276 Health Care Claim Status Request
277 Health Care Information Status Notification
278 Health Care Services Review
834 Benefit Enrollment and Maintenance
835 Helath Care Claim Payment/Advice
837 Health Care Claim



HIPAA X12 Transaction Set Parsing


Equally as important as creating transaction sets is the ability to read them, especially transactions such as the X12 835. Understanding and consuming adjudication results can be extremely vital to a customers operations.



EDI TA1 Acknowledgement Parsing

Probably the most straight forward response file to read.  The TA1 transaction set let's you know if your submitted file was successfully received by the receiving entity.  Automating the processing of these files can add value.


EDI 835 Remittance Advice Parsing


When you need to know how claims have paid it's critical that you have a utility that can not only read the 835 transaction set, but also properly post the information back to the source for proper accounting.


EDI 999 Acknowledgement Parsing


In case of an error before before your claims are adjudicated by the payor you'll want to know as soon as possible so that you can remedy the situation.  Parsing a receivers 999 can give you critical information regarding any errors your most recent submission may have encountered  Errors that occur at this level are more syntactical than business related.  




HIPAA X12 Transaction Set Creation


DoRight Solutions has years of experience in packaging customer data in the appropriate HIPAA X12 transaction sets using both the Implementation Guide (IG) and any state/plan companion guides.


HIPAA X12 Companion Guides


If you are the receiver of HIPAA EDI documents you may be in need of creating a companion guide that will inform your trading partners on the particulars of your system. Our staff at DoRight Solutions can work with you and your technical team to craft a companion guide that will meet your needs and properly inform your trading partners on specific items that you'd like to see in there submissions.In addition if you are simply looking for someone to help you decipher a companion guide in order to properly send data, we can help there as well.