Companion Technologies, which pioneered electronic claims filing for South Carolina hospitals in the 1970s, will retire its original PAID system and replace it with a new system called EnterprisEDI(TM) that will be HIPAA compliant.
Fifty-five hospitals, nearly all the hospitals in the state, use the PAID (Provider Access to Insurance Data) system. They filed 24.4 million claims through the system in 2002.
The hospitals will need to change their system before Oct. 16, a deadline mandated by the federal Health Insurance Portability and Accountability Act (HIPAA) of 1996, to comply with “administration simplification” rules regarding electronic transactions. HIPAA, which affects all of the healthcare industry, requires that all payers and clearinghouses must accept electronic transactions and that specified transactions must be in a standard format. EnterprisEDI was developed to help hospitals comply with HIPAA.
Companion Technologies’ PAID system was developed by BlueCross BlueShield of South Carolina so hospitals statewide could file claims to the company’s data center in Columbia. Eventually it was expanded to receive claims that are routed to other insurance payers and it processes Medicare claims and the military’s TRICARE health claims.
Companion Technologies was established as a wholly owned subsidiary of BlueCross in 1985 and now also develops and sells practice management and electronic medical records software for doctors’ offices nationwide.
EnterprisEDI also has some new features, including multiple views of claims such as by service date and insurance carrier, workflow control for the claims processors, interdepartmental claims routing, graphical Windows(R) presentation, field-level help linked to the South Carolina Hospital Association rules manual, drop down or right click screen help option lists, UB92 and HCFA 1500 forms display with the relevant health data, automated and on-demand eligibility checking, automated and on-demand claims status, and a relational database that provides flexible reporting options.
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