DIRECT CONNECTIVITY SYSTEM FOR HEALTHCARE ADMINISTRATIVE TRANSACTIONS

摘要

A direct connectivity system provides automated healthcare administrative transaction submission, including claim submission, eligibility verification and claim status, from healthcare service providers directly to payers. The direct connectivity system bypasses transaction processing intermediaries such as clearinghouses by directly connecting providers to payers in a many to many manner. Existing single payer web portals are supplanted by a many to many network that has a common interface across multiple payers. The direct connectivity system may receive responses directly from payers and may prepare or process the responses for a practice management program so that the service provider receives rapid feedback on the administrative transaction submission. The direct connectivity system may automatically analyze transaction file attributes to determine one or more of many payers to which to send a transaction file, from one of many providers. Batch and singleton file transfer is supported for multiple file formats, optionally with secure file transfer.