Health plans and providers throughout the United States must meet new federal requirements for processing electronic data interchange (EDI) Health Insurance Portability and Accountability Act 5010 transactions that, coupled with new International Classification of Diseases-10, some are comparing to the millennial Y2K challenge—only ten times more challenging.
Regional insurer ConnectiCare met these requirements, by adopting an EDI processing solution based on Microsoft BizTalk Server 2010. ConnectiCare was able to take advantage of the new trader partner functionality included in the product which allowsus to process both 4010 and 5010 messages. Avoiding the business-busting risk of noncompliance was only one benefit of the new solution. ConnectiCare also moved nearly all of its EDI transactions to a lower-cost, direct-connection model; gained a new tool for business intelligence; and reduced transaction processing time, freeing staff for redeployment to more strategic tasks.