Edifecs offers free CMS compliant solution for Medicare Administrative Contractors

Oct 1 2009

Edifecs, Inc., the proven leader in healthcare transaction interoperability solutions, announced today it is providing a free Commercial-Off-The-Shelf (COTS) solution that is fully compliant with the new Centers for Medicare & Medicaid Services (CMS) requirements for Medicare Administrative Contractors (MACs).

This marks Edifecs' third free software offering (after the Edifecs5010(TM) Compliance Suite and the Edifecs5010(TM) Comparison Manuals) of 2009 as part of an ongoing initiative to make it easier for healthcare entities to exchange electronic information and enable transaction interoperability. "Edifecs is continuously looking for opportunities to eliminate friction in exchanging electronic information between providers and payers. This free offering is yet another proof-point of our commitment to streamlining information flow for the healthcare industry," said Sunny Singh, CEO, Edifecs.

Edifecs' solution supports the initial steps CMS has taken to streamline the Medicare part A and B claims process. Each MAC Local Data Center (LDC) is now required to implement and execute a common edits module to validate all CMS-specific companion guide edits, which enable all MACs to perform the exact same edits and report the same errors.

While competitive solutions exist, the Edifecs solution is unique in that it satisfies the requirements as defined by CMS and offers it free to customers. The solution provides:

• Support for inbound 5010 Transactions: 837I, 837P, 276, 275
• Support for outbound 5010 Transactions: TA1, 999, 824, 277CA, 277
• Pre-build edits for HIPAA transactions
• Relaxation of edits for outbound transactions to safety edits
• Conversion of X12 to and from X12 flat file format with pre-defined conversion maps
• Support for very large files and performance
• Support to split and route 4010A1 to legacy and 5010 to new system

More details about Edifecs' offering can be found in the datasheet detailing the COTS Validation and Translation Solution for all CMS MACs.