News Update

Atlanta GA, Aug 30, 2024:

BNETAL has successfully completed a pilot of the Healthcare Claim Status (X12 276) transaction using BNETAL solutions SureEDI^® and SureDeliver^® in collaboration with a healthcare industry partner. Claim Status is the transaction between a healthcare provider and a health plan to check the status of a previously submitted healthcare claim (X12 837). This pilot showed how BNETAL solutions can provide end-to-end automation and real-time insights on the status of a claim.

Within this pilot, BNETAL solutions SureDeliver^® and SureEDI^® were used to achieve the following:

• Claim Status check in Real-time mode in conformance with CAQH CORE Operating Rules
• rich set of status and error messages that are human readable so that corrective actions can be taken by non-technical staff when mistakes occur in the initial submission
• based on client requirements, this pilot solution can be used as-is or customized, including integrating with other systems.

BNETAL SureDeliver^® is robust, secure, and ACA Section 1104 compliant gateway, which has been successfully implemented for regulatory compliance, operational efficiency and strong security. SureDeliver also provides turn-key solution for CORE Phase IV which has not yet been mandated, but is the rule governing the transport for prior authorization transactions. Within this pilot, SureDeliver® is used to provide CORE Phase IV real-time and batch transport capability.

BNETAL SureEDI^® is a robust EDI/X12, HL7 and XML processing engine with EDI mapping, validation, translation and business rule application capabilities. Within the pilot, SureEDI is used to translate the X12 transactions into business level objects for processing, and to return X12 responses. The built-in healthcare data model of SureEDI is used to enforce business rules associated with prior authorization. Extensive dynamic validation of EDI data fields is done to generate validation responses and errors.

BNETAL's nationally recognized experts in connectivity and security have worked on projects including CDC PHIN (where BNETAL provided secure data exchange solutions that are used nationwide for disease data surveillance over the Internet) can be leveraged by Payers, Providers, Clearinghouses, and Vendors to provide enterprise grade connectivity and security that is scalable, maintainable, and supported by top-notch connectivity and security experts in the industry.

For more information on SureEDI^® please email info@BNETAL.com, or call 770-399-0433 or 315-391-0716.