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

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

Solutions for Health Plans

Business Challenges

EDI Clearinghouse & Gateway

Exchange claim and payment information quickly and securely.

Business Intelligence

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

Compliance

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

Provider Portal

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

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 SNIP validation.

Health Plans get solutions. Patients and Members get care.

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.

Diverse Provider Support

Hospitals
Healthcare Systems
Behavioral Health Providers
EMS
Ambulatory Services
LTPAC, Skilled Nursing (SNF), Rehab
Chiropractors
Dentists

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 that 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 compliant and will help your organization stay compliant with any data exchanged through our network.


Ready for low-cost, flexible Clearinghouse options?