Achieve EDI Modernization using HiPaaS

The Reality​

Healthcare EDI Modernization can now be flexible, light weight with next generation API based model. HiPaaS is a next generation healthcare EDI integration platform with micro services an APIs. HiPaaS provides all EDI transactions and trading partner management with pre-integrated business processes around existing Facets, QNXT, Medicare/CMS, Epic and legacy systems.

HiPaaS Customers

HiPaaS EDI Solution

Implement any EDI/X12 transaction across payers, providers and clearing houses. Implement 834, 837, 820, 835, 27x, 274 transactions. Reconcile multiple sources of Healthcare data (Files, QNXT, Facets, EHR’s) with CMS, Medicare, Exchanges, State, and providers.

Complete EDI 837 Claims and Encounter Management Solution

Generate, Validate, Send, Receive, Reconcile 837 claims

837 Transaction Tracking

Track every file, claim and line item on out dashboard. Streamline Trading Partner setup.

837 Generation

Generate 837 I, P, D files from your local EHR application, database or salesforce. 837 Generation REST API

837 SNIP L1-L7 Validation

Validate 837 against SNIP L1-L7 before sending or loading. Validate Medicare, Medicaid, State codes. Increase AUTO Adjudication rate. Inbuilt calls to check Provider NPI, Member validation

837 Claims Edit or Manual Submission

HiPaaS offers mechanisms to route and automate claims edits. Simple screens are provided to edit the claims and then either resubmit. Interface to submit manual claim also available.

837 Claims and 835 Payments Reconcile

Make sure no claim left behind. Reconcile claims with payments and ERA. 30/60/90 days A/R report. Fix claims and resubmit. Generate 835 file or load 835 to reconcile.

Encounter Data submission

Generate, Validate and Send Encounters to state or Medicare. SNIP L1-L7 validation before sending to reduce rejections.

Claims Analytics Dashboard

Dashboard to provide claims work in progress view, daily rejection, pending view, examiner productivity view. Denial reasons and analysis. Technical and data errors views

835 Management

Send or receive 835 data. Generate 835 or load 835 in hipaas DB, Validate 835, Map 835 data to claims for payments.

277CA Management

Load 277CA and map it to claims for rejections. Generate 277CA based on claims validations. View on dashboard 277CA accepted and rejected claims data and reasons. Fix claims and resubmit.

Complete EDI 834 Enrollment and Benefit Management Solution

Generate, Validate, Send, Receive, Reconcile 834 Enrollments. Handle custom formats.

834 Enrollments Clearing House

834 Clearing house - Send 834 to multiple payers (Kaiser, BSC, UHC, Aetna, Regence, etc.)

834 Tracking and Benefit Management

Simplified dashboard and interface to track enrollment files, data and trading partners. Integrate paper enrollments. Eliminate spreadsheet with our simplified dashboard that focuses on errors and edits

834 File Generation

Generate 834 files from your local applications based on payer companion guides

834 Load and Compare

Compare against existing enrollment in QNXT, Facets and generate delta 834 files

834 Full File Compare

State/CMS full file 834 compare with QNXT data. Differences are published on simple dashboard. Compare Rate Code delta, Medi-Medi Delta

820 Cap Payment file Load and Compare

Compare State/CMS 820 Cap payments with QNXT eligibility, payment data. CFO dashboard included. Account for every incoming $ from against outgoing provider payments

CORE Real Time Transaction API - 270/271 & 276/277

Handle Real time transactions using Rest API - Eligibility, Claims Status and more...

270/271 Eligibility Medicare API

Real time eligibility integrated to Medicare HETS Web service. Our Eligibility Service provides Medical and Dental Eligibility data in simplified Json format.

270/271 Eligibility for Facets/QNXT

Get realtime eligibility from Facets or QNXT. CORE compliant

276/277 Claims Status

Get real time or batch claims status from Facets, Mainframe or CMS.


HiPaaS is HIPAA compliant 
It is cloud based, light weight, agile platform that can be running in days
Reduction of time and costs through ready to use process libraries and APIs
Saving of customer efforts with end-to-end managed services at affordable costs
High level of support and responsiveness to help solve business problems
Easy choice of offerings that can be deployed through a plug-and-play model

HiPaaS Healthcare EDI Capabilities

  • 837 Claims Submission and Processing
  • 837 Claims Edits
  • 835 Generation and Intake Processing
  • 276/277 Real-time Claim Status API
  • 270/271 Eligibility API
  • 820 Payments Processing and Loading
  • Encounter Submission
  • 834 Enrollments Submissions or Intake
  • EDI API Management
  • CCLF Claims Format Loading
  • 274 Provider Directory
  • CORE Support and Medicare Connectivity
  • SNIP L1-L7 Validation
  • Custom Data Loads
  • EDI Data Reconcilation
  • Benefits Management Application
  • Patient Mobile Engagement Application
  • Patient Portal and Applications
  • Paper Enrollments or Claims Automation
  • Full File Compare
  • Medicare Claims Validation
  • Medicare Encounter Validation and submission
  • Real time Medicare Eligibility
  • Claims Denial Management
  • Claims Revenue Cycle Mangement
  • Claims Edits
  • ACO and Operation Reports
  • Clearing House Solution
  • Mychart Integration
  • Healthcare BI Dashboard

What They're Saying

"The HiPaaS solution was easily implemented and has been a triumph for Integration. It is everything we knew put in one place that facilitates deep dive analysis in a more efficient way. This has helped SFHP to reduce the time to market and increased customer satisfaction,"
"DevCool HiPaaS did a GREAT job helping the team gain confidence in X12, so that was HUGELY helpful!  We’re confident that you’re more knowledgeable (with real-world X12 practical knowledge)”
- WPS Architect
"We could not be more pleased with HiPaaS Accelerators which contributed to our success. The level of creativity DevCool brings to solving business and professional problems is really outstanding!"
Healthcare Architect
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