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Healthcare Data Exchange

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The clearinghouse information you need at your fingertips

Use our expertise to fill in the gaps and let your people and patients be the focus

Utilizing a trusted clearinghouse service has trickle-down effects for your organization. It helps facilitate accuracy and provides access to information that leads to a patient friendly revenue cycle experience. Targeted outcomes of working with a trusted clearinghouse vendor are data exchange between provider networks, improved speed in the billing claims process, and an increase in cash flow. Your organization’s revenue cycle team will benefit by being able to focus on their designated tasks versus dedicating extra time and energy to learning the ins and outs of what a clearinghouse provides.

Healthcare Data Exchange* through Oracle Cerner is a clearinghouse service that knows information is key. Having access to comprehensive information supports quality initiatives and a patient friendly experience. That’s why our healthcare network connects providers, payers, and other healthcare entities to facilitate interoperability throughout the revenue cycle. Healthcare Data Exchange aims to address the administrative complexities of healthcare by providing payer information in a way that complies with regulatory requirements.

Healthcare Data Exchange services through Oracle Cerner include:

Helps produce accurate electronic claims. Range of services includes: claims editing and transmission, claim status, secondary billing, audit tracking and note posting for bill date, confirmation notes, and those items identified in the audit tracking process.

Transforms the administration of payment remittance into a process that targets efficiency and cost-saving. When combined with electronic funds transfer (EFT), it supports faster deposit of payments and cash reconciliation.

Aims to accelerate the receipt of payments and connects online payment capabilities with our ePayments service.

Responds to insurance coverage inquiries that help hospitals, clinics, physicians, and other providers verify coverage details and identify requirements that must be completed prior to care.

Enables electronic referral and precertification inquiries and sends notifications and referral authorization requests through the Integrated Notifications and Referrals Service.

Automates the remittance and posting process of both insurance and patient payments directly to a healthcare's local bank for more timely recognition of revenue and risk reduction of mishandled/lost payments.

Targets increasing collections at or before the time of service by estimating patients' financial responsibility.

Maximizes the efficiency of your business office and supports patient friendly communications. Provides data transmission and processing, customized formats, and mailing for statements and collection letters.

Addresses verification and payment risk assessment solutions that target efficiencies in the registration, financial counseling, and collections workflows.

Healthcare Data Exchange press is a web-based application, HIS-agnostic, and browser-based eligibility verification solution that automates the delivery of results through the automated batch feature.


What are some of the organizations that Oracle Cerner Healthcare Data Exchange works with?

Healthcare Data Exchange works with managed care organizations, Blue Cross/Blue Shield plans, national commercial plans, regional plans, government plans (Medicare and Medicaid), physicians, physician groups, clinics, hospitals, hospital chains, and integrated health networks. Healthcare Data Exchange provides Electronic Data Interchange (EDI) services to over 1,450 of the largest healthcare delivery, acute care, and ambulatory care organizations nationwide, and we are currently working with over 900 payers. Our open network approach enables any healthcare organization interested in participating to join the network with the goal of making it easy for clients to join the network, both from a business and technical standpoint.

*Healthcare Data Exchange has received full accreditation by the Electronic Healthcare Network Accreditation Commission (EHNAC), whose function is to promote administrative simplification and cost savings in the healthcare industry and to promote EDI-industry standards, known as EHNAC Criteria. Healthcare Data Exchange has achieved CAQH® Committee on Operating Rules for Information Exchange (CORE®) Phase II Certification. The CORE Seal was awarded after successful completion of CORE certification testing - a process ensuring that healthcare organizations can electronically exchange or access patient insurance information according to the CORE rules. Healthcare Data Exchange is HIPPA compliant. The certification from Optum provides clients with an independent verification that our products are capable of producing transactions that satisfy HIPAA required X12 transaction syntax, data content, code set validity, Implementation Guide requirements, and transaction functionality. The electronic health network (EHN) recertification approved by the Maryland Health Care Commission (MHCC) demonstrates that standards intended to facilitate high quality business operations and sound privacy and security policies have been met.

Vision: To leverage the value of data across health networks to facilitate better outcomes.

Mission: To lead the healthcare community in helping to streamline and prioritize standards, integration, and information exchange by delivering software services that aim to connect and elevate the associate, consumer, client, and partner experience.

Revenue Cycle Management Offerings