Started in 2000, HealthSpring has quickly grown into the largest coordinated care plan organization in the country. With their primary focus being Medicare Advantage plans, HealthSpring manages plans in 12 states including a stand-alone, nation-wide, prescription drug plan. Having years of experience in the healthcare industry, Focused E-Commerce was the best fit in helping HealthSpring transition to newly mandated changes from the Department of Health and Human Services. Updates to the X12 standard have forced every company submitting healthcare claims via EDI to a newer version called of X12 called 5010.
An EDI vendor who keeps current with new standards
We have deep roots in the EDI for Healthcare field and are familiar with the intricacies of CMS and the ratings your company must maintain. Utilizing tools developed specifically for this field, we have an extensive EDI mapping library that makes updates to mapping standards quick and easy. Our unique HealthCare Portal application helps companies bypass the need for third-party claims providers. Saving thousands of dollars annually, the HealthCare Portal gives you the ability to submit claims and eligibility requests via EDI directly to CMS.
Focused E-Commerce takes pride in knowing the healthcare landscape and the constant changes regulatory agencies make.
Having the proper tools to support EDI 5010 and other mappings and transformations makes Focused E-Commerce the premier EDI and ERP consulting company. We have lengthy field experience implementing EDI with Sterling, Biztalk, QNext and other claims management systems, in addition to Oracle, SAP and many other ERP systems.
What is ensuring your HIPAA compliance worth to your business? Balancing the time-consuming tasks of a trading network along with CMS and government changes are two full-time jobs. We can help you find parity to let you concentrate on the right priorities to grow your organization.