MediHawaii offers a complete solution through a fully integrated operational outsource option for clients. This includes workflow and document management software that seamlessly connects with our EDI clearinghouse systems and full mailroom management with image processing and OCR/Paper-to-EDI/Printing services.
Insurers
Streamlined Administration
Our flexible connectivity platform helps clients reduce administrative expenses and improve healthcare transaction processing without much change to their back-end systems and operations. We enable organizations to receive medical bills and records electronically, process them electronically, and pay them electronically. MediHawaii is also able to turn process data into business intelligence to drive performance gains for the client organization.
Our Toolkit
On the front-end, we deliver advanced provider connectivity, EDI aggregation and pre-adjudication services to deliver cleaner transactions to your existing systems . Once you receive the medical bills and records electronically, our workflow platform is available to carry out your unique internal processing requirements. On the back-end, we offer a suite of payment solutions and remittance delivery methods to complete the transactions and update your systems accordingly.
Managed EDI Gateway
Heavy Lifting
For a payer, MediHawaii simplifies electronic delivery of data without heavy overhead or resources through a single point of connectivity to workers compensation, auto, personal injury providers, and group health providers.
Simplified Connectivity
Supports adoption by healthcare providers through simplified connectivity – MediHawaii supports virtually all data formats and connectivity methods.
Smart Integrations
Supports adoption of EDI by healthcare providers through MediHawaii’s existing integrations with leading practice management software / EMR vendors.
Streamlined Solutions
To help ensure the highest level of access and EDI submission rates from healthcare providers, MediHawaii has multiple submission solutions and technologies to accepts transactions from all healthcare provider and facility types.
Ensured Options
Ensures submitters have options when choosing to submit EDI – MediHawaii supports existing inter-connectivity to other clearinghouses.
Managed Oversight
Manages ongoing adjustments and compliance with jurisdictional and EDI requirements. These are handled by MediHawaii without effect to customers.
Business Process Outsource
The general implementation outline below gives a top-level view of what an implementation with MediHawaii would look like, and the approximate time it would take to complete.
Standard implementations can be completed in 7-90 business days depending on the level of client resources assigned to the process. MediHawaii assigns a dedicated operations representative to support your firm in the implementation process. We will manage the coordination of multiple vendors and third-parties to ensure a successful and timely integration for all . The key implementation phases include:
Proposal and contracts — Negotiate terms, pricing, and establish am implementation timeline.
Kick-off conference call / meeting — Exchange specifications and documentation.
Development and functional testing.
Training and marketing plan rollout.
Ongoing metric monitoring and reporting.
Unlimited Pre-Adjudication
How can we help your organization improve medical bill receipt, internal processing, and payment issuance/delivery?
Hawaii specific rules and edits ensure bills are scrubbed and complete. This delivers cleaner bills to you, the receiver – and instant notification to submitters for any deficiencies/inaccuracies in the submission process.
Claim indexing/matching (hosted or direct API connectivity to backend systems) ensures inbound bills have valid claim numbers.
MediHawaii works with clients to build the most efficient “pre-adjudication” processes without taxing internal resources or systems.
Vendor indexing/matching logic provides workflow routing of bills to appropriate receiving parties.
The client does not pay for rejected submissions even though they were processed by MediHawaii for the client according to client business rules. Client only pays for submitted bills that cleared validation and were actually received by client.
MediHawaii technical support staff have over 25 years of experience delivering EDI implementations and bring a high-level of technical expertise to the process.
Technical Details
MediHawaii supports compliant use of American National Standards Institute (ANSI) Accredited Standards Committee (ASC) X12N Health Care Insurance standard transactions, custom transaction formats, business-to-business (B2B) integrations, and robust workflow electronic data interchanges.
State and Federal Compliance
At MediHawaii, the confidentiality and integrity of protected health information is one of our highest priorities. We fully support and are compliant with the Health Insurance Portability and Accountability Act (HIPAA), HITECH, and all state jurisdictional requirements.
Accreditations and Certifications
The MediHawaii SaaS platform developed by WCEDI has been EHNAC HNAP accredited, and is actively working towards attaining its HITRUST and SOC2 certifications in 2018.
