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HIPaA Solutions
 
Simplifying the complex process of Healthcare Administration
 
 
The Health Insurance Portability and Accountability Act of 1996 Public Law 104-191 ( HIPAA ), a sweeping legislation designed to reform and simplify healthcare administrative processes was passed by Congress.

HIPAA affects any entity that transmits Healthcare information. The law addresses three primary functions and streamline operations for payors as well as providers.

Administrative Simplification
Privacy
Security

The administrative simplification portion of HIPAA is aimed at reducing administrative costs and burdens in the health care industry by adopting and requiring the use of standardized, electronic transmission of administrative and financial data.

HIPAA is the first comprehensive law that mandates the protection of privacy of patients by securing Individual Health Information (IHI). Privacy protection involves operational transformation healthcare entities.

The Security segment of the law mandates the protection of Healthcare information via Administrative and Physical measures as well as Technical Security mechanisms and services.

Clavib can help you approach HIPAA not simply as a compliance issue but as an opportunity to transform your health services and help you realize continuous process improvement leading to improved profitability and productivity at all levels.

 
 

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Clavib's HIPAA compliance offering
Healthcare organizations face a fast approaching deadline for HIPAA compliancy and believe that instead of engaging in straightforward compliance one should utilize this opportunity to embrace a broader transformation effort to the next generation of healthcare administration where systems and business operations are more flexible and better able to adjust quickly and economically to future changes in business operations and strategy.

Clavib's HIPAA solution framework includes a full service portfolio to assist you in this transformation. Our comprehensive HIPAA compliance framework comprises of both a strategic and tactical approach and includes the following:

Education and Awareness
Assessment Toolkit
Analysis and solution design
Systems remediation and enterprise application integration
Training and Compliance management

With rapidly approaching deadlines, we understand that some of the phases of the compliance efforts would have been undertaken by your organization, and believe that we could assist you in any or all phases of the compliance efforts.

Clavib has the methodologies, tools, business alliances and healthcare expertise to help you meet the critical challenges of HIPAA compliance. We understand the processes of healthcare enterprises and are adept at quickly identifying process re-engineering needs, technology integration improvements to enable you to be HIPAA compliant. Click here to find out more about our HIPAA service offering.

Education and Awareness

We provide a collection of HIPAA education materials from executive-level overviews and seminars to detailed guidelines for HIPAA Privacy and Security. This will enable your management to better understand HIPAA regulations and their effect on your organization and will prepare you for undertaking the steps towards compliance.

Assessment Toolkit

Our Assessment toolkit is a set of frameworks and templates to assist your organization in performing a HIPAA diagnostic and gap analysis. Components include an assessment project estimating tool, HIPAA questionnaires, pre-defined assessment deliverable templates and a HIPAA Tracker database. The tracker tool facilitates the collection of information and identifies the gaps in HIPAA compliance.

The outcome of this is a GAP analysis report that highlights areas where work needs to be done to take the organization towards HIPAA compliance. The GAP analysis also provides a Road Map for future activities and gives the your organization an estimate of the Time and Effort and cost involved in the drive to achieve compliance.

Analysis and Solution Design

We will work very closely with your team in conducting an in-depth analysis of the systems, processes that need re-engineering, code-remediation and application integration and assist in designing a comprehensive solution to address the identified systems and operations.

Systems remediation and enterprise application integration

We offer a proven methodology and history in remediation of health care systems and have extensive experience in building data exchanges and selecting, designing and implementing these exchanges using the latest data exchange and ETL tools. The deliverable of this phase is your organization becoming HIPAA compliant with the data transaction set exchange.

Training and Compliance Management
Clavib will provide in-depth HIPAA process and technology management training solutions to your organization. In addition we will work with independent HIPAA certification organization to achieve HIPAA compliant certifications for your organization.

Technology Solution
In 1996, Congress passed the Health Insurance Portability and Accountability Act (HIPAA) to eliminate the inefficiencies in the healthcare system by standardizing the electronic exchange of administrative and financial data. HIPAA regulations affect almost every entity involved in the healthcare community.

The use of proprietary data formats for handling healthcare information is the leading cause of administrative inefficiencies. The constant need to deal with exceptions, multiple formats, and rising transaction volumes place a cumbersome burden on the various constituencies. Further exacerbating the problem is the increased expectation from today's consumer in regard to access of information with a high level of privacy. Constituencies such as providers, vendors, and other partners in the healthcare community are demanding, sometimes as a contingency to do business, or requesting automated self-service solutions for handling a wide variety of information needs.

Clavib's DataBridge integration solution addresses a wide range of integration needs for organizations affected by the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

In addition to exchanging standard HIPAA transactions, Health plans, health care providers, and intermediaries can also fully integrate new transactions with new and existing enterprise applications and data.

The DataBridge solution includes predefined definitions and data maps for the HL7, UB92, and NSF standards, as well as the complete ASC X12N Version 4010 standard for HIPAA:

  • 837 Health Care Claim: Dental, Professional, and Institutional

  • 270/271 Health Care Eligibility Benefit Inquiry and Response

  • 278 Health Care Services Review - Request for Review and Response

  • 276/277 Health Care Claim Status Request and Response

  • 834 Benefit Enrollment and Maintenance

  • 835 Health Care Claim Payment/Advice

  • 820 Payroll Deduction and Group Premium Payment for Insurance Products

  • 275 HL7 attachments (within X12 binary segments)
The DataBridge technology solution uses the EDISphere technology and is a general-purpose platform that one can use to integrate applications, interfaces, and data resources across the enterprise. Its consistent architecture and toolset deliver a quick-to-market file translation solution including all of the following features:
  • Graphical specification of integration workflows connecting trading partners with back-end applications and data resources on multiple platforms.

  • Powerful any-to-any and many-to-many interface transformations, minimizing or eliminating programming.

  • Code-free adapters for commercial applications, messaging middleware, Internet transports, relational DBMS, file systems, and utilities.

  • Included interface templates for X12, EDIFACT, and other e-business standards.

  • Importers for interface creation from XML, DTDs, copy books, DBMS catalogs, and other Metadata Graphical definition of interfaces to legacy applications and data

  • In-Built Testing and simulation features.
 

Translator 101 White Paper

DataBridge Solution White Paper

 
 
 
 
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