StrataCare’s eBilling Enterprise Solution™ is a compliant-ready eBilling solution designed to assist clients who are required by state jurisdictions to accept and process electronic bills and attachments.
Currently, Texas and Minnesota are the only states requiring providers and payers to electronically exchange medical bills, with California expected to do so in 2010. Providers must submit their workers' compensation bills electronically to insurance payers using national standard electronic billing formats (ANSI X12 837 – bill, ANSI X12 275 – attachments). Payers must take appropriate steps to accept provider eBills and return electronic ERAs (Electronic Remittance Advice) back to providers (ANSI X12 835).
The eBilling Enterprise Solution can reduce administrative costs through an efficient transition from paper billing to eBilling. It supports workflow technology that integrates StrataCare’s premier bill review software with the advanced connectivity platform provided by our clearinghouse partner, Capario (formerly MedAvant Healthcare Solutions). Complimenting the eBilling Enterprise Solution is our AdjusterPortal™, which allows claims adjusters to authorize or deny payment for the eBills online. Upon completion, bill processing results and EOR data are transmitted to the Payer’s claim system for traditional check and EOR issuance.
Key Features & Benefits
- Compliant-Ready - StrataCare’s eBilling Enterprise Solution meets all existing jurisdictionally mandated eBilling statutes.
- Clearinghouse Services - Fully HIPAA compliant clearinghouse services are provided by Capario, the nation’s leading provider of real-time claims processing and business intelligence solutions using HIPAA adopted ANSI 4010A1, 837, 835, and 275 formats.
- AdjusterPortal - Claims adjusters have online access for quick and efficient adjudication of medical eBills.
- StrataWare - eBills are re-priced through our highly accurate and fully automated rules-driven bill review engine with minimal human intervention. When necessary, fully configurable routing rules can direct medical eBills to review specialists for in-depth analysis and adjustments.
- State Reporting – StrataCare provides State Reporting services including an advanced State Reporting Module™ (SRM) for reporting medical transactions. The SRM captures and submits all required medical bill and payment data to jurisdictions requiring state reporting.
