| 1. What is expEDIum Framework? |
| 2. What is Unique about expEDIum Framework? |
| 3. How can your Engine guarantee the correctness of the generated output? |
| 4. How long will it take to enable a custom application that uses expEDIum X12N Engine? |
| 5. Does the expEDIum X12N Engine provide CPT/HCPCS, ICD-9 validations? |
| 6. How is the expEDIum Engine packaged and priced? |
| 7. How does it compare with other EDI Translator? |
| 8. What are the various expEDIum Adapters? |
| 9. Can you build custom adapters using your expEDIum framework? |
| 10. What is expEDIum Claims Reconciliation? |
| 11. What is “Electronic Claims Life Cycle”? |
| 12. What are the various “targeted” market segments for these products? |
| 13. What are the platforms supported? |
| 14. Do you provide “direct” payer connectivity? |
| 15. I have heard about something called Gap Analysis. What is it? |
| 16. Do we have to fill in missing data each time we translate a new file? |
| 17. Do you have programming services? |
| 18. Can expEDIum help our office become HIPAA compliant? |
| 19. Do you have solutions/products for billing services? |
| 20. Do you have solutions/products for clearinghouses? |
| 21. Do you have solutions/products for payers? |
| 22. Do you have solutions/products for hospitals/clinics/practices? |
| 23. Is expEDIum able to function properly over a networked environment? |
| 24. Is there a learning curve in using expEDIum with all its features? |
| 25. Can you provide reference clients? |
| 26. Can multiple X12N / HIPAA versions co-exist? |
| 27. Do you have an expEDIum Engine that handles ONLY 837 and 835 transaction sets? |
| 28. How do I eliminate the need for a clearinghouse? |
| 29. What is the performance of expEDIum Engine and the adapters? |
| 30. Do you have any-to-X12N / HIPAA kind of adapters? |
| 31. Do you have any adapters that connect to a database? |
| 32. How do you interface with Practice Management Systems (PMS)? |
| 33. How do you interface with existing billing or healthcare solutions? |
| 34. Do you work with Healthcare Software vendors or Solutions providers? |
| 35. Do you have any interfaces to Accounting Systems to post ANSI Remits? |
| 36. Do you have any tools for Claims Processing / BPO? |
| 37. Do you have any tools for Home billing and Collection agencies? |
| 38. What kind of sample data do you need to evaluate our requirements? |
| 39. Do you have documentation on expEDIum X12N / HIPAA Engine API? |
| 40. Who do we contact at iTech regarding HIPAA related products and solutions? |
| 41. How many claims are being processed by iTech’s clients using iTech's products and solutions every day? |
| 42. How many carriers have validated the data transformed by these expEDIum Adapters? |
| 43. What kind of security do you provide for protected healthcare information (as it is referred to as “PHI” in HIPAA regulations)? |
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Does your HCFAClaims DB Adapter support claims for all specialties like anesthesia, chiropractor, pediatrics etc? Does HCFAClaims DB Adapter include an exhaustive database covering these specialties? |
| 45. How long does it take to customize an adapter to support a proprietary database? |
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1. What is expEDIum Framework?
Answer: The expEDIum X12N / HIPAA Engine is a Java-based, robust translation engine that supports all the eleven HIPAA mandated transaction sets. This engine supports 837 Professional, 837 Institutional, and 837 Dental, 835, 270, 271, 276, 277, 278, 820, 834 and 997 transaction sets. The expEDIum X12N / HIPAA Engine supports HIPAA transaction set versions v4010 and v4010A1. A comprehensive API layer on top of the engine consists of over 2400 API calls covering all HIPAA transaction sets. The API is used to develop custom adapters that process any standard or proprietary Healthcare format files. |
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2. What is Unique about expEDIum Framework?
Answer: The expEDIum X12N / HIPAA Translator / Engine is a multi-threaded application using Java technologies, which ensure portability across various platforms. It has been built with world-class software development practices and quality assurance standards that ensure a high degree of flexibility, scalability and adaptability to cater to any future need. This is a high performing Engine as the X12N schemas are hard-wired in the program itself unlike traditional EDI Translators / Engines that read the mapping information from secondary store.
For more information about our expEDIum engine go to
http://www.itechws.com/x12nengineapi.html |
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3. How can your Engine guarantee the correctness of the generated output?
Answer: The X12N Engine ensures “syntax” compliancy only. The "semantics" validity of the data must be ensured by the custom applications that are built around the X12N Engine API. iTech has built several readymade products and solutions around the expEDIum X12N Engine and several million healthcare claims in various formats including NSF, HCFA Print Image, HCFA/UB04 CSV have successfully been translated and have reached hundreds of payers across the United States in the last few years. |
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4. How long will it take to enable a custom application that uses expEDIum X12N Engine?
Answer: This would depend on the Transaction sets that need to be supported and the amount of edits that are required to be programmed. It would typically take 2 to 4 weeks to build a typical custom application that supports one transaction set such as 837(P). This effort would include data gap analysis, expEDIum X12N Engine API learning, custom programming, data validation (with HIPAA Validation sites) and internal testing. |
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5. Does the expEDIum X12N Engine provide CPT/HCPCS, ICD-9 validations?
Answer: No, the engine does not provide CPT/HCPCS, ICD-9 validations. This is typically provided from the applications that are built around the Translator. We do have products and solutions that perform CPT/HCPCS, ICD-9 validations. Please refer to our expEDIum Claims Portal Solution. http://www.itechws.com/claimsportal.html |
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6. How is the expEDIum Engine packaged and priced?
Answer: The pricing is based on per server and transaction sets that need to be supported. Typically, the pricing does NOT depend on volume of transactions, number of CPUs used and number of users. Please contact us (hyper link to http://www.itechws.com/contactus.html) for a pricing proposal with your requirements. |
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7. How does it compare with other EDI Translator?
Answer: Typical EDI translators provide EDI Transaction set mapping on a store and use this mapping when processing EDI transactions. expEDIum works differently, expEDIum EDI Engine Architecture “hard-wires” the EDI Transaction mapping information for a given vertical or process .It provides a rich API that is used to build EDI-aware applications rapidly. It’s robust and is capable of processing several hundred thousand transactions per day on appropriate hardware. |
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8. What are the various expEDIum Adapters?
Answer: iTech Workshop markets a variety of readymade Healthcare adapters built using expEDIum X12N / HIPAA Engine. These adapters support formats such as NSF 2.0, NSF 3.01, UB-92 v5.0/6.0, NSF 3.01 DMERC, NSF 3.20D, NSF 2.01u ERN, Envoy NSF and HCFA 1500 Print Image formats. |
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9. Can you build custom adapters using your expEDIum framework?
Answer: Yes, we can build custom adapters rapidly for any other Healthcare formats as per the requirement of our clients. |
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10. What is expEDIum Claims Reconciliation?
Answer: The expEDIum Claims Reconciliation solution (eCR) connects existing Billing Systems and Practice Management Systems directly to Payers and makes the claim life cycle management more efficient.
For more information about our expEDIum engine go to http://www.itechws.com/claimsreconciliation.html |
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11. What is “Electronic Claims Life Cycle” ?
Answer: The claims in the form of data on paper or in old electronic form (NSF) is processed by the Clearing houses and Billing services and passed on to the Payers .The Payers send in a positive response if the data received is in correct format. eCR solutions can be used by the Clearing houses, Billing services as well as the Payers. |
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12. What are the various “targeted” market segments for these products?
Answer: iTech Workshop’s products are specifically targeted at small and medium healthcare enterprises like Medical Billing Bureaus, Clearinghouses, Payers, Hospitals and Clinics. |
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13. What are the platforms supported?
Answer: expEDIum solutions are Java based and platform independent they work on any platform Windows or Linux which has “Java Runtime Environment (JRE)” installed on them. The JRE can be downloaded for free from the Sun site. |
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14. Do you provide “direct” payer connectivity?
Answer: Yes, our eCR solution directly connects existing Billing systems and Practice Management Systems to Payers. |
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15. I have heard about something called Gap Analysis. What is it?
Answer: Gap Analysis is used by organizations to cross-reference their legacy application data sets to the HIPAA-formatted transactions for compliance to the X12N / HIPAA Implementation Guides adopted under HIPAA. |
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16. Do we have to fill in missing data each time we translate a new file?
Answer: No you don’t have to, because our adapters have a default GAP mechanism to fill in data that could be missing from the input healthcare format files but are required for generating complete X12N / HIPAA files, by default. |
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17. Do you have programming services?
Answer: Yes, we do provide programming services based on the clients requirement at additional cost. Typically, our programming services are limited to healthcare vertical and revolve around our products and solutions. |
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18. Can expEDIum help our office become HIPAA compliant?
Answer: Yes, we have solutions that enable small to medium Healthcare enterprises to transform existing healthcare data to HIPAA compliant data and effectively manage the electronic claims flow and remittance flow between the various carriers and the billing entity. |
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19. Do you have solutions/products for billing services?
Answer: Yes, we do have readymade products and customized solutions for billing services. |
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20. Do you have solutions/products for clearinghouses?
Answer: Yes, we do have readymade products and customized solutions for clearinghouses. |
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21. Do you have solutions/products for payers?
Answer: We have the architecture for a payer’s solution that is dependent on our expEDIum X12N / HIPAA Framework. We can rapidly develop a solution based on the client’s requirement. |
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22. Do you have solutions/products for hospitals/clinics/practices?
Answer: Yes, we do have readymade products and customized solutions for hospitals and clinics. Due to a level complexity….or due to a level learning required to install and use our products we are not positioning our products for practices. |
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23. Is expEDIum able to function properly over a networked environment?
Answer: Yes, expEDIum can function over a networked environment. |
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24. Is there a learning curve in using expEDIum with all its features?
Answer: It’s quite simple to use expEDIum, we have the documentation and we can also give you a “remote demo” to make you familiar with the process of installing and running the solutions. It takes less than 30 minutes to install, run the software and process one or more files. It takes between 10 to 20 hours to setup our product to support one small practice (with 20 rendering providers) and start sending X12N / HIPAA Claims (837P/I/D) to one or more payers. Post sales, we will provide a level of support that is unsurpassed. |
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25. Can you provide reference clients?
Answer: Yes, you can visit the Resource center section of our website to see the testimonials of our satisfied clients. |
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26. Can multiple X12N / HIPAA versions co-exist?
Answer: We don’t have multiple versions co-existing at this point of time, if later on at some point of time we have a situation like this (multiple versions co-existing )then we will have to check out whether there will be any conflicts. |
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27. Do you have an expEDIum Engine that handles ONLY 837 and 835 transaction sets?
Answer: Yes, we have an expEDIum ‘Thin’ Engine that supports only 837/835 and 997 transaction sets. We have separate adapters for handling 837 (NSFClaims, HCFAClaims and UB92/UB04 Claims) and 835 (NSFRemits) transactions. |
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28. How do I eliminate the need for a clearinghouse?
Answer: The expEDIum Claims Reconciliation (eCR) directly connects existing billing systems and Practice Management Systems to Payers thus removing the need for clearing houses. |
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29. What is the performance of expEDIum Engine and the adapters?
Answer: Our expEDIum X12N / HIPAA Engine Architecture “hard-wires” the EDI Transaction mapping information and it delivers high performance. We have seen 200+ typical claims being (NSF 3.01 claims with multiple service lines) processed per second. Our architecture is scalable. |
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30. Do you have any-to-X12N / HIPAA kind of adapters?
Answer: No, as of now we do not have any such adapter, which can convert any file format to X12N / HIPAA. We can build custom adapters on request. |
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31. Do you have any adapters that connect to a database?
Answer: Yes, we do have adapters that connect to an ODBC /JDBC compatible database (SQL Server, MS Access). We custom program interfaces connecting our adapters to any other open or proprietary database on request, this will include additional charges on top of our standard list prices. |
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32. How do you interface with Practice Management Systems (PMS)?
Answer: Practice Management Systems generate data in NSF or HCFA formats which is then taken as input by our “readymade” expEDIum adapters to generate output in the desired X12N / HIPAA format. |
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33. How do you interface with existing billing or healthcare solutions?
Answer: As they generate data in NSF or HCFA formats which is then taken as input by our “readymade” expEDIum adapters for conversion to the desired X12N / HIPAA format. |
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34. Do you work with Healthcare Software vendors or Solutions providers?
Answer: Yes, we have Healthcare software vendors as our clients. |
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35. Do you have any interfaces to Accounting Systems to post ANSI Remits?
Answer: Yes, we have a readymade product “NSFRemits” that transforms ANSI Remits (835s) into NSF 2.01u ERN that is supported by most accounting/billing systems. Any other interfaces/formats can be programmed on request. |
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36. Do you have any tools for Claims Processing / BPO?
Answer: Yes, we have products like the ANSI creator and eCR which could be used for Claims processing, BPO etc. |
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37. Do you have any tools for Home billing and Collection agencies?
Answer: Yes, we do have adapters and tools that could be used to by Home billers and by Collection agencies. We can also build custom tools/solutions on request. |
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38. What kind of sample data do you need to evaluate our requirements?
Answer: Send us only “deidentified” data; please DO NOT send us any claims containing live patient data. However, we do protect all data that we receive and we can sign any NDA that will protect your data if you have to send us additional data. |
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39. Do you have documentation on expEDIum X12N / HIPAA Engine API?
Answer: Yes, we do have documentation in Javadocs format. You can request for this from our website link at http://www.itechws.com/evaluationsoftware.html |
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40. Who do we contact at iTech regarding HIPAA related products and solutions?
Answer: Contact us at contactus@itechws.com |
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41. How many claims are being processed by iTech’s clients using iTech's products and solutions every day?
Answer: Several million claims have been processed using iTech’s suite of products and sent to several carriers across the USA in the last few years. You can find the current statistics on our home page. |
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42. How many carriers have validated the data transformed by these expEDIum Adapters?
Answer: Our adapters are used to create X12N data compatible with a variety of payers and clearinghouses across the USA and the current list of supported Payers and Clearinghouses is available on our website at our home page. |
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43. What kind of security do you provide for protected healthcare information (as it is referred to as “PHI” in HIPAA regulations)?
Answer: Our products/solutions support Standard secure transportation mechanisms (such as HTTPS and Secure FTP) and encryption of data using PGP (Pretty Good Privacy) and ZIP with password. Additional secure transport or encryptions schemes can be supported on demand (note this is custom work). |
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44. Does your HCFAClaims DB Adapter support claims for all specialties like anesthesia, chiropractor, pediatrics etc? Does HCFAClaims DB Adapter include an exhaustive database covering these specialties?
Answer: No, it does not. The HCFAClaims DB Adapter evaluation includes a basic database that is used for demonstration ONLY. Typically, we create custom adapters that connect to any proprietary databases and that perform the custom mapping to equivalent X12N EDI. Whatever specialties the proprietary database supports, the expEDIum custom adapter would map that to equivalent X12N EDI mapping any speciality specific data. Similarly, we can provide you with UB92Claims Custom adapter too that would work any proprietary databases on demand. |
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45. How long does it take to customize an adapter to support a proprietary database?
Answer: It depends on how exhaustive the database is. It typically takes between 2 to 4 person weeks to create an expEDIum Custom adapter that works with a proprietary database seamlessly creating 837(P,I,D) and other transaction sets. |
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