Health Insurance

BNETAL has been providing solutions and services to health insurance industry for more than 15 years. Our solutions for ACA compliant HIPAA EDI/X12 transactions, and our expertise in CAQH CORE Operating Rules can be leveraged by health insurance clients to simplify administration and improve efficiencies.

  • BNETAL SureEDI® is a powerful EDI mapping, validation and adjudication software. It supports dynamic mapping from EDI formats to business level objects. EDI maps can be defined for different transactions and can be tailored to trading partners. Users can also define dynamic rules for validation and adjudication. Many fully built EDI mapping templates help get you started so you can hit the ground running and quickly implement the validation and adjudication rules using the templates. Easy to use extensible framework that can provide custom extensions for both validation and adjudication. SureEDI® can be installed stand-alone or with BNETAL's SureDeliver®, to support end-to-end (data content and transport) processing.
  • By providing a robust turnkey product for EDI mapping, validation and processing, BNETAL offers to health plans, clearinghouses, healthcare providers, third-party administrators and billing systems vendors a great solution for their health insurance transaction processing needs.
  • Please see SureEDI® page for more information.

BNETAL SureDeliver®

Medicare/Medicaid IT
  • As part of a consulting engagement, BNETAL consulting has collaborated with CMS on the CMS esMD project, and prior to that, on the CMS Medicaid Information Technology Architecture (MITA) project. During a HIMSS meeting in Atlanta, BNETAL assisted the MITA team in show-casing the CAQH CORE Connectivity interfaces to demonstrate interoperability.
    • BNETAL solution SureDeliver® has a gateway implementation that complies with the data transport requirements of CMS esMD, and that can easily integrate with and augment existing revenue cycle management systems to submit electronic documents to Medicare
    • BNETAL knowledge of Electronic Medical Document Submission (esMD) standards can be leveraged by Healthcare Provider Vendors and Health Information Handler vendors to send data to Medicare/CMS.

Image 2

Key Clients