HealthSmart EDI

HealthSmart EDI provider and vendor solutions

HealthSmart EDI program offers a Full Service Healthcare EDI Clearinghouse. It is open to all providers in the healthcare community. The goal at HealthSmart is to give network providers the highest level of customer service possible. HealthSmart is engineered with the latest technology and is committed to meeting all HIPAA requirements in healthcare EDI services.

HealthSmart Information System’s Electronic Data Interchange (EDI) Clearinghouse is leading the way in technology. EDI Clearinghouse is a highly scalable, configurable, and extensible system leveraging XML technologies. It serves to manage claims processing for robust partner interfaces. The system is built upon Microsoft .NET framework and uses SQL server for its database. HealthSmart supports a portal allowing quick access to the site from any secured location. Security for the EDI system is role-based. This allows companies to establish access to the system on an individual employee basis. HealthSmart offers HIPAA compliant transactions to all of its customers.

HealthSmart EDI Services

  • Commercial claims (Aetna, CIGNA, Humana, etc…) to providers
  • Free government claims to participating carriers
  • Eligibility verifications
  • Claim status inquiry
  • Electronic remittance advice (ERA) for auto payment posting
  • e-Paper (Print-Mail Services)
  • Patient statements

HealthSmart EDI Benefits

HealthSmart EDI offers providers to experience the following benefits:

  • Faster reimbursement
  • Reduce rejected claims (Clean Claims)
  • Decrease time-intensive manual tasks
  • Increase productivity and efficiency
  • Improve cash flow

HealthSmart EDI Types of Claims

  • HCFA-1500
  • UB-92
  • UB-04
  • dental
  • institutional and professional

By partnering with HealthSmart, this clearinghouse ensures the transition is painless. As a provider, when you become a HealthSmart Information Systems Partner, you can immediately utilize the many features available via your POMIS vendor and HealthSmart’s EDI clearinghouse. HealthSmart recommends POMIS vendors that not only are familiar with the system, but also are partners with HealthSmart Information Systems. The primary goal is to provide one-stop-shopping for the EDI healthcare community.

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