Healthcare

APP Design’s extensive healthcare knowledge can help your organization meet it’s goals. APP’s team has worked in the healthcare field for many years, including working on the first community healthcare network the Wisconsin Healthcare Information Network, Western New York HealtheNet , and Healthcare Extranets of New Mexico. In addition to our RHIOnet product for securely linking healthcare information systems, we’ve also aided organizations with integration projects and HIPAA compliance.

HIPAA

In brief, HIPAA imposes the following standards on healthcare organizations:

 

  • Security - Protection of the patient’s electronically stored or transmitted healthcare information.
  • Privacy - Confidentiality of the patient’s healthcare information, and specific rules for disclosure.
  • Transactions - ANSI X12 transaction format standards for the electronic request and response of healthcare information.
  • Codes - Mandated use of specific code sets for uniformity of transmitted data (ICD-9, CPT-4, etc.).
  • Identifiers - Unique identifiers for providers, employers, health plans, etc.

 

APP Design can help healthcare organizations comply with HIPAA standards in the following ways:

 

Security/Privacy

APP Design’s experience in the healthcare field lets us understand the extensive security requirements of HIPAA. We help organizations audit their existing information technology security policies and develop HIPAA compliant polices. If necessary we can enhance existing system security with modules from the APP Anvil™ application server.

Transactions

APP Design’s RHIOnet X12 transaction set helps organizations comply with HIPAA mandated standards. In addition, we can create custom interfaces to existing legacy systems, then use RHIOnet’s X12 transaction service to handle incoming X12 transactions, creating "instant" X12 compliance for the organization. Running on top of the APP Anvil™ application server, the service supports the following transactions out of the box:

 

  • 270/271 Health Care Eligibility/Benefit Inquiry and Information Response
  • 276/277 Health Care Claim Status Request and Response
  • 278 Health Care Services Request for Review and Response
  • 278 Health Care Services Review - Notification
  • 278 Health Care Services Review Inquiry/Response

APP Design’s X12 process includes helpful documents, such as transaction mapping spreadsheets shown above, to speed your compliance process.

Codes/Identifiers

As of this writing, HIPAA standards for identifiers has not been finalized. In the interim, APP understands that each organization can have its own set of identifiers for providers. RHIOnet can substitute the appropriate provider identifier for the destination organization "on the fly", as the transaction is transmitted. This saves organizations from maintaining and synchronizing multiple identifier lists.

 

We also have an extensive collection of code maps required by HIPAA’s X12 specifications including 270, 271, 276, 277, and 278.