Information Builders Case Studies LifeWatch Automates Healthcare Claims Processing With Integration

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	LifeWatch Automates Healthcare Claims Processing With Integration Information Builders

LifeWatch Automates Healthcare Claims Processing With Integration

Information Builders

Technology Category	Application Infrastructure & Middleware - API Integration & Management Application Infrastructure & Middleware - Data Exchange & Integration
Applicable Industries	Healthcare & Hospitals
Applicable Functions	Procurement
Use Cases	Regulatory Compliance Monitoring Remote Asset Management
Services	Software Design & Engineering Services System Integration
Challenge	LifeWatch, a provider of remote heart-monitoring and home sleep-testing services, was faced with the challenge of complying with new governmental requirements to support new EDI standards for medical claims processing. Failure to comply would result in fines and payment delays. The company had to build integration technology to comply with the new standards by the government deadline. LifeWatch processes medical claims for devices and patient services with more than 10 different insurance claims clearinghouses, each with its own unique trading partner agreements. The company used electronic data interchange (EDI) technology to process charges using a 4010 format established by the Health Insurance Portability and Accountability Act (HIPAA), but a recent updated HIPAA standard now requires healthcare organizations to support the EDI 5010 format. Read More
About Customer	LifeWatch is a company that provides remote heart-monitoring and home sleep-testing services for the diagnosis of obstructive sleep apnea. Through a comprehensive platform of technologically advanced monitoring devices and services, LifeWatch helps physicians detect and analyze symptoms before they become major health problems. With more than 500 employees, LifeWatch is a wholly owned subsidiary of LifeWatch AG, a leading healthcare technology and solutions provider based in Switzerland. The company is headquartered in Rosemont, IL, and processes medical claims for devices and patient services with more than 10 different insurance claims clearinghouses, each with its own unique trading partner agreements. Read More
Solution	To comply with the new government regulations, LifeWatch deployed iWay integration software solutions to manage claims processing with more than 10 different claims clearinghouses. The company used the iWay Service Manager Pro Edition Bundle and the HIPAA Accelerator (including Trading Partner Manager) to automate claim remittals and payment processing. iWay’s powerful combination of integration and transformation tools enabled LifeWatch to use its existing information systems in new ways. Information Builders helped LifeWatch's development team understand how to build the correct interfaces, set up the data so it could feed into iWay, and map all their business rules to meet government requirements. iWay Service Manager became the integration foundation at LifeWatch. iWay Trading Partner Manager simplified the creation of trading partner agreements and managed the EDI collaborations with the various clearinghouses that interface with LifeWatch. The iWay HIPAA Adapter understood the EDI formats, and, together with Service Manager, parsed and transformed the EDI 5010 transactions into the appropriate backend formats. Read More Log in to view content
Contents

Technology Category

Application Infrastructure & Middleware - API Integration & Management

Application Infrastructure & Middleware - Data Exchange & Integration

Applicable Industries

Healthcare & Hospitals

Applicable Functions

Procurement

Use Cases

Regulatory Compliance Monitoring

Remote Asset Management

Services

Software Design & Engineering Services

System Integration

Challenge

LifeWatch, a provider of remote heart-monitoring and home sleep-testing services, was faced with the challenge of complying with new governmental requirements to support new EDI standards for medical claims processing. Failure to comply would result in fines and payment delays. The company had to build integration technology to comply with the new standards by the government deadline. LifeWatch processes medical claims for devices and patient services with more than 10 different insurance claims clearinghouses, each with its own unique trading partner agreements. The company used electronic data interchange (EDI) technology to process charges using a 4010 format established by the Health Insurance Portability and Accountability Act (HIPAA), but a recent updated HIPAA standard now requires healthcare organizations to support the EDI 5010 format.

About Customer

LifeWatch is a company that provides remote heart-monitoring and home sleep-testing services for the diagnosis of obstructive sleep apnea. Through a comprehensive platform of technologically advanced monitoring devices and services, LifeWatch helps physicians detect and analyze symptoms before they become major health problems. With more than 500 employees, LifeWatch is a wholly owned subsidiary of LifeWatch AG, a leading healthcare technology and solutions provider based in Switzerland. The company is headquartered in Rosemont, IL, and processes medical claims for devices and patient services with more than 10 different insurance claims clearinghouses, each with its own unique trading partner agreements.

Solution

To comply with the new government regulations, LifeWatch deployed iWay integration software solutions to manage claims processing with more than 10 different claims clearinghouses. The company used the iWay Service Manager Pro Edition Bundle and the HIPAA Accelerator (including Trading Partner Manager) to automate claim remittals and payment processing. iWay’s powerful combination of integration and transformation tools enabled LifeWatch to use its existing information systems in new ways. Information Builders helped LifeWatch's development team understand how to build the correct interfaces, set up the data so it could feed into iWay, and map all their business rules to meet government requirements. iWay Service Manager became the integration foundation at LifeWatch. iWay Trading Partner Manager simplified the creation of trading partner agreements and managed the EDI collaborations with the various clearinghouses that interface with LifeWatch. The iWay HIPAA Adapter understood the EDI formats, and, together with Service Manager, parsed and transformed the EDI 5010 transactions into the appropriate backend formats.

Impact #1	LifeWatch was able to comply with the new HIPAA standards.
Impact #2	The company was able to leverage existing technology investments.
Impact #3	LifeWatch was able to provide secure and appropriate access to strategic, clinical, and other key information.

Impact #1

LifeWatch was able to comply with the new HIPAA standards.

Impact #2

The company was able to leverage existing technology investments.

Impact #3

LifeWatch was able to provide secure and appropriate access to strategic, clinical, and other key information.

Benefit #1	Dramatically reduced manual effort for hundreds of thousands of annual claims.

Benefit #1

Dramatically reduced manual effort for hundreds of thousands of annual claims.

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Overview

LifeWatch Automates Healthcare Claims Processing With Integration

Operational Impact

Quantitative Benefit