Data flow in the healthcare industry is at its peak and continuously rising. But, alongside this data surge, there is one concern that is cropping up and it is that of data security and management. To address a gamut of pressing issues, data-driven healthcare is being used as a critical and transformative solution. In fact, around 59% organizations have put this on their priority list to successfully incorporate data and information exchanges.

Since the organizations have been grappling with the major issue of data management and administration, it is expected that EDI adoption will continue to rise and global markets may cross $1.68 billion by 2018. Other than the data security and management issues, the expanded adoption has been fueled by the increasing healthcare and administration costs along with incorporating government regulations and provisions.


What Created the EDI Upsurge?


Last few years have completely transformed the healthcare industry! There have been many changes with respect to healthcare accessibility as well as information processing. The drastic shift in the ways the industry used to run before are basically the end products of a number of federal and state government rules and regulations proposed by the Affordable Care Act and Healthcare Insurance Portability and Accountability Act (HIPAA).


The new set of rules and mandates was mainly introduced to enhance the efficiency and effectiveness of the system and to standardize the data transmission process with Electronic Data Interchange (EDI) that protects the confidentiality and privacy of patients’ healthcare information.


Though aimed at improving the structure of the healthcare industry, these mandates created more challenges and complexities for the organizations to comply by them and manage the confidential data. To meet the needs, a number of methods were introduced to manage open enrollment and claims processing. These methods included certain third party solutions, custom made in-house systems or SaaS based tools to help organizations adhere to the standards.


How An EDI System Can Ease The Processing?


An EDI system can pose as the vital solution to these pressing concerns revolving around costs, data security and administrative hassles. With a system in hand, you can easily plan, implement and manage an EDI environment in the most cost-effective manner.


Here’s how EDI will streamline the information processing:

EDI 834 Mapping & Standardization


To create automatic information mapping rules and convert them to normalized format, EDI 834s with any combination of fields and data formats can be accepted. Once converted, they can be utilized by the backend systems. As a result, the entire processing will be accelerated eliminating any manual interventions and error probability.

Use Templates to Execute Specific Tasks

In order to perform the common steps of data transformation and routing, a “templated” process can be created by the system on the basis of the type of data that is being received from a specific data source.


SOA Reusability

The service-oriented architecture reusability is one of the prime reasons why an EDI system can help you save time and resources in carrying out the similar processes. For instance, it allows you to copy EDI 834 format of an existing vendor and accordingly modify and apply it to another vendor if it requires a similar format. Thus, you can save on your repetitive efforts on performing similar tasks.

Therefore, with the system, automated EDI transmissions will take place among payer, healthcare providers, brokers and carriers. This will facilitate improved accessibility to the data in real-time that will further accelerate the processes. Moreover, it will become easier for organizations to monitor, backup and secure data in a comprehensive manner and keep track of all EDI activities through all-inclusive reporting.


TeemWurk brings you the 3D EDI tool that comes with the flexibility to scale as per the changing business and regulatory requirements.  The tool simplifies mapping of HIPAA compliant segments in 834 transactions. It also enables users to setup EDI feeds within a few minutes, sync enrollment data in any required format and create schedules for automated transmissions. Thus, it allows reporting on all HIPAA and ICD coding requirements ensuring organizations’ complete control over data exchange and its security.