Interoperability

Connect disparate systems and data

Make real-time data exchange a reality

From administrative transactions like eligibility, claims and authorizations to clinical data exchanges like ADT feeds and care plan changes, you’ve got a lot of data to aggregate, integrate, and synthesize into useful, accessible knowledge. Smart Exchange does just that.

Our dedicated integration team covers everything from EDI X12 transactions and HL7 transactions to API integrations and a large library of pre-integrated healthcare partners.  Claims systems? Care management systems? Wellness partners? CDHP? We’ve got it covered, saving you resources and time.

We’re fixing EDI

As one of the foundational underpinnings of daily data exchange, EDI is a source of resource constraints and logistical issues within many health plans. From start to finish, we help build, maintain and monitor the critical EDI transactions that support activities throughout the portal. Both real-time and batch transactions are available.

EDI Transactions

  • Eligibility and Benefits (270/271)
  • Claims Status (276/277)
  • Claims Submission (837)
  • Remittance Advice (835)
  • Referral Status and Submission (278)
  • Enrollment (834)

Embracing and advancing the use of APIs

Our health plan clients’ needs for both batch and real-time data exchange are highly varied, but a common theme has emerged around transitioning to APIs and other real-time web services connections. The foundations of the Smart Series platform are built upon highly interchangeable mechanisms for data consumption and sharing, creating great opportunity to leverage alternative connectivity to not only the health plan’s internal administrative systems but also those of their partners.

“The first and only portal solution with full API integration into the market-leading claims systems.“

What Questions Can We Answer?