Notes

Slide Show

Outline

1	HealthCare eCommerce: Claims and Payment/ERA
2	Agenda HealthCare eCommerce HealthCare eCommerce Architecture HealthCare Pipeline Components Demonstration
3	Why Is Medical Billing Different From Commercial Billing? Claims are NOT invoices Third party payers Secondary, third, … multiple payers Third party payees
4	Healthcare Claims/Payment/COB COB: Coordination of Benefits
5	HealthCare Payment/ERA (835) Information Flows
6	HealthCare Payment (835) Claim Balancing
7	HealthCare eCommerce Architecture
8	HealthCare eCommerce - Why Pipeline?
9	HealthCare eCommerce
10	HealthCare Claims eCommerce Processing - Example
11	HealthCare Payment eCommerce Processing - Example
12	HealthCare eCommerce Transmit Architecture
13	HealthCare eCommerce Receive Architecture
14	HealthCare eCommerce Pipeline Components
15	HealthCare Claims Pipeline (NSF->HIPAA->Payer)
16	HealthCare ERA/835 Pipeline (HIPAA->AP)
17	HealthCare Open Buying on the Internet (OBI) Pipeline
18	Internet Transmit Pipeline using XML
19	Demonstrations
20	Generic Map: NSF 2.0 to HIPAA 837 Professional
21	Generic Map: UB92 Version 4.1 to HIPAA 837 Institutional