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Home > Products > Exchange
Exchange:


Increasingly, trading partners are looking to establish direct data interchange amongst themselves and their trading partners in order to create efficiencies and reduce the overall cost of transactions.

Built on SOA, Orbit Exchange (also referred to as Health Information Network (“HIN”) is a comprehensive solution for the exchange of electronic transactions between trading partners. It connects healthcare trading partners, regardless of the legacy systems or data formats used. Modular in design, it is a completely secure solution of intelligent, interlocking business rules and translation engines that facilitate the transfer of data across multiple layers, between associated business partners.

  • Eligibility Connector is a real-time or batch connector to member enrollment systems, data warehouses, and clearinghouse switches. This tool builds and delivers member inquiry transactions or member rosters / panel listings in the desired format and then conveys the designated response and benefit plan information to the user interface.

  • Case Management Connector is a real-time or batch connector to case management systems, data warehouses and clearinghouse switches. It builds and delivers referral requests and pre-certification transactions in the desired format and then conveys the designated response to the user interface.

  • Enrollment & Benefits Management Connector is a batch or real-time connector that allows employee and health plan data to be uploaded directly into the payer enrollment system. Member and plan data is loaded into a data mart, which retains the benefits plan information by group ID and then customizes it at the member level. The system has built-in interfaces to primary HR systems including SAP and PeopleSoft.

  • Claims Connector is an application that acts as a filter to claims systems, clearinghouses, or payers. It has the ability to validate and process claim files with payer-specific or system-specific edits, map & translate data to / from, as well as import & export data, to multiple systems.

Connector’s are also available for electronic remittance, pharmacy reporting, claim status, financial transactions, and lab results.

     
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