For Health Plans
Flexible solutions that fit your needs
All-inclusive solutions built on 25 years of EDI experience
X12 File Support
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
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.
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.
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.
Integrate quickly with a simple API for bulk eligibility requests.
Rest assured that your transactions are handled in compliance with HIPAA and CAQH CORE, positioning you for compliance as well.
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:
Behavioral Health Providers
Ambulatory Services / EMS
LTPACs, SNFs, Rehap, Home Health, and Hospice
In the case that an electronic solution isn’t viable, we offer best-in-class Paper-to-EDI solutions.
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.
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?