Claims-2-Payer

Claims-2-PayerProduct Summary

  • No longer be concerned about a payer’s interpretation of HIPAA 837, let us do that for you.
  • Payer-specific data stored either in your system or the Claims-2-Payer™ system.
  • 837 output generated from non-837 input

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The Claims-2-Payer™ system extracts data from your claims system and formats it for delivery of claims information to payers.  Using our DaFoDiL™ data format description language, the Claims-2-Payer™  system makes it easy to comply with each payer’s unique interpretation of HIPAA 837 specifications, NSF, or their own proprietary encounter formats.

The Claims-2-Payer™ system is approved for submissions to:

Blue Cross of California      Blue Shield of California

Care1st Healthplan             Health Net of California

Molina Healthcare               Blue Cross Blue Shield of Massachusetts

Tufts Health Plan                 Trans Union

PacifiCare                            Cigna

Aetna                                   Sharp

MDCare                               …and many more.     Call for the most current list

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The Claims-2-Payer™ system provides the following:

  • All interfaces are tested against payer’s requirements
  • Multiple formats to handle all payers
  • Edit files based on extensive data checking
  • Validation specific to the payer
  • Data translation
  • Store payer-specific data either in your system or in the Claims-2-Payer™ system
  • Batch Control information reporting
  • User-controlled data extraction so you get the claims you need
  • Data extraction kept separate for each payer
  • Use editor for resubmitting rejected data
  • Simple and easy to use
  • Generate 837 output from non-837 input