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Medi-Cal Compare with DHCS (California Department of Health Care Services)

Compare elements of incoming and outgoing X12 834 , 837 and 820 files with core system to make sure compliance.




HiPaaS


HiPaaS X12 Medi-Cal Compare features at a Glance :


  • Compare daily and monthly 834 file with QNXT.
  • Compare daily 837 file against QNXT.
  • Compare 834 outbound against 834 inbound.
  • Compare 820 against 834 and QNXT
  • Compare 820 against outbound Payments and cap master
  • Compare Active, Hold, Term against 834
  • Compare 12 months of membership history
  • Compare Plan Integration Errors
  • Compare Duplicates
  • Compare Providers PCP assignments
  • Compare RateCode differences
  • Compare Dual Coverage differences
  • Compare Claims preprocessing, post process status - Pending, Accepted, Paid
  • Compare Claims payments against 835 and ERA
  • Compare Examiner Productivity
  • Inbuilt dashbaord with drill down capability.
  • Easy to implement and integrate.
  • Up and Ready in weeks.
  • Automated comparision.
  • X12 Connectivity to DHCS
  • SOAP and Web Services Connectivity to DHCS / HETS
  • X12 to Json mappings of DHCS data.
  • DHCS Companion guide implementation for 837, 834, 270 / 271, 820, 835 and other 27x transactions.
  • Real time and batch transaction implementations.
  • DHCS data mapped to HiPaaS Database for enhanced Analytics

HiPaaS Claims 837 Compare dashboard

Claims dashboard with claims and payments reconciliation.
Watch HiPaaS Claims 837 Compare Demo:

HiPaaS 834 Compare Dashboard

Enrollments dashboard with membership reconciliation.
Watch HiPaaS Enrollment Demo: