Electronic Data Interchange (EDI) is a technology used to exchange documents and data in a standardized electronic format. In healthcare, EDI is crucial for processing transactions like medical claims, eligibility inquiries, and claim status inquiries. In 2023, the Director of Benefits Programs at the University of Massachusetts (UMass) needed a formal EDI system built for their student and faculty dental plans. UMass evaluated several companies that had outdated and inflexible systems, with an equal amount of work required on UMass’s end to build a solution. Eventually, their IT team referred them to HIPAA Vault, after contracting us in the past for secure website hosting.
The Challenge:
The UMass Benefits Program lacked an EDI system and was managing a large database with student, employee, and postdoc information. This data, in CSV format, needed to be filtered and converted into a standardized EDI 834 document format and securely transmitted to their dental provider.
Solution Overview:
The HIPAA Vault team leveraged our expertise in EDI compliance and data conversion to help the UMass Benefits Programs department with the required data conversion. Our experienced team created a custom script to convert UMass’s CSV file into the appropriate EDI 834 format. Our solution maintained data integrity and security throughout the process, while also providing added value:
- Modern Solutions: Our team has current and expanding expertise in EDI software solutions. We leverage cutting-edge technology to seamlessly develop a robust system.
- Independent Work to Save Client Time: Throughout the building process, our team assumes complete responsibility for developing the solution. This not only saves our clients precious time and resources but also creates a more cohesive solution.
- Customization: We use client feedback to develop a solution that addresses their unique challenges. With UMass, we made many adjustments based on their specific requests.
Implementation and Maintenance:
During the implementation process, UMass submitted several requests to modify the syntax and formatting of the EDI documents. Even slight deviations from EDI document rules, such as improper capitalization or exceeding character limits, necessitated manual intervention. Whenever UMass faced errors, they notified our team. Our engineers promptly fixed issues and took preventive measures to avoid future roadblocks.
Results:
We successfully created an EDI system for the University of Massachusetts, enabling efficient management of their student and staff dental plans. This new system replaced a redundant, labor-intensive manual process with a fully automated solution, freeing up a generous amount of time for their team to focus on more important work. UMass is very satisfied with the project, and we have since developed a similar solution for their vision care plan.
The implementation of an EDI system provided a comprehensive solution for the UMass Benefits Programs department. With the expertise of the HIPAA Vault team, the university successfully converted their CSV data into a standardized EDI 834 format, ensuring the integrity and security of sensitive information. The modern solutions, independent work approach, and customization capabilities offered by HIPAA Vault contributed to a seamless and efficient process. Our ongoing maintenance and prompt issue resolution further enhanced the effectiveness of the implemented EDI system.
About HIPAA Vault:
HIPAA Vault is a leading provider of HIPAA-compliant solutions, enabling healthcare providers, business organizations, and government agencies to secure their protected health information from data breaches, threats, and security vulnerabilities.