Payers and Third Party Administrators

Utilizing the HeW communication gateway, Payers experience more efficient operations and reduced administrative costs by simplifying the exchange of transactions with the healthcare community.

We value our payer partnerships and are continually working to enhance them to jointly reduce healthcare costs.

Exclusivity Benefits

Health insurance carriers who designate HeW as their exclusive clearinghouse can take advantage of the following benefits:

  • Single point of receipt and distribution of electronic transactions
  • Reduced IT costs associated with maintaining communications and application codes associated with multiple sources
  • Transactions are more easily rerouted and reconciled
  • Increased volume of electronic transactions
  • More consistent special editing and transaction processing
  • Maintain HIPAA compliance, including ANSI 5010 conversion
  • Overcome system limitations with custom translation services
  • Experience higher first-pass rates
    • Custom editing suites
    • Duplicate claim checking
  • Improve Provider Relations by increasing efficiency and streamlining processes
  • Reduce administrative costs associated with paper claims and support calls
  • Eliminate expensive OCR processes and experience more efficient COB processing by increasing EDI transaction volumes
  • Solutions for your participating provider community
    • Limited EDI Package: Enables providers to exchange supported transactions with your organization only, at no cost to the provider.
    • Full Revenue Cycle Management Solutions Package: Enables providers to communicate electronically with any TPA or Payer, monthly fees do apply to provider.

Services available to HeW partners are endless! Some examples include:

  • Customized Payer specific editing
  • Duplicate claim checking
  • Custom translation services (from ANSI to proprietary formats)
  • Translation for eligibility and claim status for web services
  • Translation of returned data to generate 271 and 277 responses
  • Customized paper reduction solutions for the Payer partner's participating provider community that do not have other opportunities or needs to use a clearinghouse. Such as:
    • Use of HeW browser-based client software for claims entry
    • Access to this application through a link on Payer's website and/or HeW website
    • Basic transaction editing and routing of erred transaction reports
    • Remote application training, on-line training, web site support and toll free customer support

Contact HeW Sales Department

Download these brochures:

Payer Partners

HeW values its partnerships with the following Exclusive Health Insurance Carrier Partners:

 

 

 



Pricing

Payers are assessed a per claim fee based solely on the volume of accepted claims transmitted from HeW. Additional fees apply for other transactions.

Payers who designate HeW as their exclusive clearinghouse will take advantage of the benefits detailed under the exclusivity benefits page.

  • Lower per claim fees than other payers
  • Volume enhanced program that decreases per claim fees as volume increases
  • No additional charge for other transactions
  • No implementation fees
  • No other hidden costs

Contact HeW Sales Department

Click here to download a brochure.