Turn Paper EOBs into 835 ERAs: Cut the Manual Workload While most healthcare payments today are processed electronically, some payers still send paper Explanations of Benefits (EOBs). These documents contain the same data as their digital counterparts sent via EDI – the 835 Electronic Remittance Advice (ERA). Even if paper EOBs make up just a … Read More →
How to Map a Medicare 271 to a CWF: A Quick Guide for Healthcare Data Teams When working with Medicare eligibility data, one common task is mapping a 271 Eligibility Response to Common Working File (CWF) data structures. While both formats serve to describe a patient’s eligibility, they follow different standards – 271 follows the … Read More →
Understanding the Most Common Eligibility Errors in Healthcare EDI In healthcare, accurate eligibility verification is critical for ensuring timely claims processing and avoiding costly rework. Electronic Data Interchange (EDI) transactions, particularly the 270 (Eligibility Inquiry) and 271 (Eligibility Response), are key tools for checking a patient’s insurance coverage. However, even with automation, eligibility errors are … Read More →
Implementing Safeguards for HIPAA Compliance: A Three-Pronged Approach Achieving HIPAA compliance is not just about understanding the rules – it’s about putting them into action. One of the most critical requirements of the HIPAA Security Rule is the implementation of safeguards that protect electronic Protected Health Information (ePHI) from unauthorized access, use, or disclosure. These … Read More →