Transaction Support

Smart Data Solutions uses an internally developed translator, allowing us flexibility in meeting client requirements. For example, we can do custom mapping for items such as repriced reason code descriptions. This, in-turn, improves downstream claim processing.

iStock_000000310291Small.jpg

Transaction Support

Smart Data Solutions provides the full spectrum of transaction processing services. Recognizing that these functions are essential for businesses to succeed but are also serious drain on resources, we can assume the day-to-day tasks to help streamline operations and allow our clients to focus on their core business and achieve profitable growth.

  • 5010 compliance
  • 835 - Claims Payment Support
  • 834 - Eligibility Submission
  • 837 - Claim Submission
  • 997 - Functional Acknowledgement
  • 276 - Claims Status Request
  • 277 - Claims Status Response
  • 278 - Pre-certification & Referral
  • 270 - Eligibility Request
  • 271 - Eligibility Response
  • 820 - Group Premium Payment
  • Proprietary Formats
  • Electronic Remittance Advice (ERA) 
  • Workers Comp eBill & Attachments
  • Faxes
  • Provider DDE
  • Enrollment Forms
  • Spousal Coverage Verification Forms
  • Radiology Claims
  • Non-Standard Forms
  • Practice Management System
  • Attachments

Transaction Generation

Smart Data Solutions uses an internally developed translator, allowing us flexibility in meeting client requirements. For example, we can do custom mapping for items such as repriced reason code descriptions. This, in-turn, improves downstream claim processing.

Transaction Validation

Smart Data Solutions transaction processing includes a versatile transaction validator. Specifically, we are able to validate HIPAA transaction types 1 through 5. We can also perform more granular validation edits including customer specific rules. Please note that transaction validation is done on a "per trading partner" basis. Smart Data Solutions can easily accommodate diverse transaction requirements for internal and external entities. Smart Data Solutions paper sourced 837 transactions are used by payers and networks across the country.

Transaction Conversion

Smart Data Solutions performs format conversion for Healthcare customers across the country. Our transaction conversion includes the parsing of source transactions to our database. We then build transactions based on requirements of the receiving party. Generated transactions can be a variance of a standard or proprietary format.