For Health Plans

Flexible solutions that fit your needs

All-inclusive solutions built on 25 years of EDI experience

X12 File Support

Multiple Connections

Security & Compliance

Electronic and Paper Solutions

We work with teams across the nation and our expert support teams are all located in the U.S.

Solutions for Health Plan

Business Challenges

EDI Clearinghouse & Gateway

Exchange claim and payment information quickly, securely, and with a best in class support team.

Electronic Pre-Authorization Portal

Reduce Pre-Authorization turnaround time with a fully functional Pre-Auth and embeddable portal.

Electronic Attachments Portal

Streamline your attachments with a completely electronic solution.

Multi-payer Provider Portal

Your providers can submit through the MYUHIN portal for all of their EDI needs.

EDI Enrollment

Optimize your EDI enrollment; we field the provider requests and deliver the information you need.

Data Transformation and Enrichment

Remove processing snags by receiving data in a format that is optimal for your system.

Payment and Remittance

Simplify your remittances; send a single file and we’ll split each remittance out to the correct destination. 

Payment Integrity

Reduce the burden on your system and decrease turnaround time for rejections with customizable SNIP validation and clearinghouse eligibility rejections.

Reporting and Business Intelligence

Gain insight into your EDI workflow and traffic, then create optimum results.

Simple APIs

Integrate quickly with a simple API for bulk eligibility requests.

Compliance

Rest assured that your transactions are handled in compliance with HIPAA and CAQH CORE, positioning you for compliance as well.

Provider Portal

Expand your options when providers submit through MYUHIN, a portal for claims, eligibility, pre-authorizations, attachments, EDI enrollment, and more.

Low-cost EDI transactions and expert support teams you can count on

UHIN’s solutions go beyond the transactions. We have been serving health plans since 1993, reducing their administrative burdens and simplifying the complexity of administrative engagement between payer and provider. Our clients’ success is our priority and our teams go above and beyond what a traditional clearinghouse would do to maintain that high quality of service. By providing real expertise, constantly innovating our solutions, and engaging with all levels of the healthcare industry, we are uniquely positioned to help your organization succeed.

Our Electronic Data Interchange (EDI) platform, encompassing a wide range of services and solutions that connect providers, payers, billers, Medicare, Medicaid and more. We work with all stakeholders to ensure everyone can succeed. Providers get paid faster. Health Plans get solutions. Patients and Members get care.

Diverse Provider Support

We support your diverse continuum of Providers in a wide range of specialties:

Hospitals

Healthcare Systems

Behavioral Health Providers

Ambulatory Services / EMS

Chiropractors

Dental Offices

LTPACs, SNFs, Rehap, Home Health, and Hospice

Paper-to-EDI (P2E)

In the case that an electronic solution isn’t viable, we offer best-in-class Paper-to-EDI solutions.

Mailroom Management

 Our mailroom services offer real time inventory and workflow tracking, ensuring efficient, accurate, and timely process management. Our proprietary Mailroom Accountability and Control System (MACS) provides the foundation for these services. At a high level, MACS provides three major functions:

-Dashboard tracking of all mailroom activities, including process alerts

-Accountability and performance monitoring for all human processes

-Automation of routine management functions

Scanning & Data Capture

Data security, ISO-compliant audit system and data capture workflow applications are key components for scanning and data capture.

Scanning and data capture through UHIN are fully customizable and highly automated.

Optical Character Recognition (OCR)

Key From Image (KFI)

Quality Control Module

Base Double Key Module

Enhanced Double Key 

 

Machine Learning Models

 Clean Data – All the data the goes into the model is cleaned

Build Model – Initial models are tested and iterated  

Validate Model -Models are validated against live data

Model Production – Tested models are moved to production and monitored. 

Audit & Iterate Model – Model results are audited for accuracy and automation.

Rigorous Compliance

UHIN is HIPAA and CAQH CORE compliant and will help your organization stay compliant with any data exchanged through UTRANSEND.

Ready for low-cost, flexible Clearinghouse options?