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 and CAQH CORE, 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 and CAQH CORE compliant and will help your organization stay compliant with any data exchanged through our network.