Important Steps When Establishing a Secure Electronic Portal for Healthcare Claim Submission by Providers

providers are increasingly looking to establish electronic portals to integrate with their existing workflow and technology. Two important processes in setting up a portal: establishing a secure connection and testing sample claims in all formats.

St. Paul, MN (I-Newswire) September 25, 2012 - As the healthcare industry increasingly transitions to electronic processing of claims, providers continue to look for simple solutions for submitting claims. Providers are looking for a solution that will easily integrate with their existing workflow and technology as well as be able to provide an easy-to-use claim submission gateway.

One popular solution for the electronic submission of healthcare claims is to establish an electronic portal for submitting claims. However, as the information on any healthcare claim is highly sensitive, there are very important considerations to be looked at when choosing to set up a portal.

“Smart Data Stream Clearinghouse has years of experience providing custom automated, real-time, easy-to-use portal interfaces that accept any form type and includes extensive reporting features,” affirms Mark Fogarty, Smart Data Stream’s EDI Business Development Manager. “Our set-up process is fast and simple and has no IT requirements for set-up or use.”

Smart Data Stream outlines two important processes when getting an electronic portal up and running. The first important consideration is to establish a secure connection, and the second is to test sample claims in all formats.

It is important to establish a secure connection because security is extremely important whenever handling any medical information. The most common option is setting up a secure FTP site that the provider can access with any web browser. In addition, if claim files are being extracted from a PMS or billing software system, the connection between the system and the portal must also be made via a secure connection.

The second step of setting up an electronic portal is testing claim accuracy. This step is just as important as the first as it limits errors once the client goes live. When testing, all form types that will be submitted must be tested, as data capture on each form type is unique. Once all form types are sent in for testing, via the above-determined secure method, all reconciliation processes, error handling, and reporting functions must be tested as well. After all parties have confirmed the accuracy of all processes the portal is ready to go live and receive claims.

“For Smart Data Stream, the average time frame to get our customized electronic portal up and running is 20 business days from start to finish,” continues Pat Bollom, co-owner of Smart Data Stream Clearinghouse. “Once the customized portal is set up our clients see claims being paid faster, saving them both time and money.”