ELECTRONIC TRANSACTION SERVICES

Coming soon in 2004 – Medicare Part A & B.

Health Net Data Link, Inc., Linking Payers and Providers electronically HIPAA Compliant Electronic Data Interchange( EDI) EDI transaction Type HIPAA Electronic Eligibility and Benefit Verification. (270/271) Claims Status (276/277) Claims History (276/277) Claims Filing (Instutitional and Professional) (837) Referrals and Authorizations – (inbound and outbound) (278) Remittance Advice and Explanation of Benefit (835) Electronic Funds Transfer (835) Claims Edit transaction.

Electronic Transaction Services are available through HealthNet Data Link, Inc. (HDL), an eHDL company. "A leader in local and regional payer connectivity."

HDL offers integrated, HIPAA-Compliant Electronic Data Interchange (EDI) services over a secure encrypted data network. Using HDL’s Electronic Transaction Services (ETS), access to multiple Payers are available thorough a single login HDL-WEB Browser Interface.

HIPAA-Compliant Hosting and interfaces for back-end connectivity are available for Payers such as HMO’s, PPO’s, PHO’s, IPA’s, MSO’s, Insurance Companies, and Employer Benefits Organizations.

Experience The Difference!

From eligibility to remittance, HDL gives health care organizations a single login solutions to all electronic transactions.

• Hospitals
• Physicians
• Provider Networks
• HMO’s/PPO’s/MSO’s/IPA’s/PHO’s
• Billing and Collections Companies
• Long-Term Care Facilities
• Out-Patient Centers
• Government Health Programs

Eligibility and Benefit Verification
Single login access is provided to multiple Payers, using HDL’s WEB Browser. Alternative access is available, using Software Batch PC/Windows, Green Screen Terminal Emulation, Batch Download, and Magnetic Swipe Card.

While HDL offers access to national Payers, its business is focused on connecting local and regional Payers in key health care markets such as – Florida, Louisiana, Texas, Oklahoma, and New Jersey. Access is available for Government and Commercial Payers, including Payers such as Medicaid, Aetna, AvMed, BCBS, Cigna, Humana, JMH Health Plan, and United.

Referral and Authorization Services
Reduce time consuming phone calls, required to make referrals and receive authorizations.

HDL Electronic Referral and Authorization Services available from selected Payers.

Claims Submission Services

• HDL is an All Payers Clearinghouse – Your One-Stop Claims Submission Shop.
• HDL’s Electronic Transaction Services accepts and transmits claims from
  • Practice Management Systems
  • Hospital Information Systems
  • HDL’s Browser-Base Direct Data Entry Interface System
• HDL Handles all formats for Professional and Institutional Claims … NSF, HIPAA-837, UB’s, etc.

Claims Status Services

• HDL downloads Status on Multiple Claims, electronically at once.
• HDL’s On-Line Claims Status Inquiry provides instant Status on claims, prior to and following adjudication for payments.

Claims Clean-Up Services

• Avoid payment delays associated with initial Claims Submissions.
• HDL Electronic Transaction Claims Clean-Up Services provides Primary and Clinical Edits before claims are submitted to Payers.

Remittance Advice
HDL’s Remittance Advice Services provide payment information on behalf of Payers against Explanation of Benefits (EOB) for contracted customers.

Electronic Transaction Services for Payers
Payers, eliminate headaches associated with building and deploying HIPAA-compliant transactions interfaces.

HDL provides turnkey hosting interfaces that Payers can use to connect to Providers.

HDL is focused on increasing local and regional Payer connectivity.

Web Access
HDL provides a single login, encrypted WEB Browser access to all applications with seamless back-end integration. HDL’s Web Browser Interfaces are user-friendly and easy to navigate. Special features include rapid response, multi-user and multitasking capabilities, and easy setup. No installation of software is required. Access is available through HDL’s web site www.ehdl.com. Installation, setup, training, and support can be done On-Line, or On-Site.

Software Batch PC/Windows Interface
HDL’s Software Batch Application accepts medium to large batches in Windows Microsoft Word, Excel, Text, or ASCII formats, allowing contracted customers to merge, edit, update, save, and/or delete batches.

Batch Download Services
Contracted customers can submit a Batch Download to HDL in any format (Excel, Access, Oracle, ASCII, Flat File, Report Format, Word, Text, etc.). HDL Data Conversion and Clean Up Services are available before queries are submitted at the customers’ request. HDL EDI Batch Processing is available for Eligibility, Referral, Authorization, Claims Submission, Claims Status, and Remittance. Customized user-defined fields are allowed for generating special reports.

HDL’s Batch Services have been utilized by facilities to enhance collections on Self-Pay and Indigent Patients, who might otherwise convert from indigent to Medicaid within 12 months of services being rendered.

Green Screen Terminal Emulation
Hospitals and Insurance can use their existing Legacy Systems to access HDL’ s Information Network.

HDL can link to Legacy Mainframes and AS-400 Systems common in hospitals and insurance companies, utilizing LU2 and LU62 Terminal emulation interfaces.

Magnetic Swipe Card
HDL offers a Point-of-Sale (Swipe Card) Device that allows contracted customers to perform Medicaid eligibility verification transactions in areas where computers are not available.