RelayPayor overview

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“We did not know how we were going to create 5010 data for our testing. TestTrack will be a great help in preparing for 5010.” – Regional Blues Plan RelayHealth, McKesson’s connectivity business, offers real-time solutions to streamline interactions throughout healthcare, connecting patients, providers, pharmacies, and payors. The net result: improved care, faster access, lower costs and enhanced bottom lines. RelayHealth Serves more than 2,000 hospitals, 200,000 physicians, and connects with more than 1,800 health plans, and securely processes more than 12.8 billion financial and clinical transactions annually. Pioneered online communications with physicians and offers the most advanced practice connectivity solutions available. Hospital solutions provide a secure, accessible infrastructure with the most evolved HIE solution available. Pharmacy solutions support more than 90% of the nation’s pharmacies with customized solutions that improve patient safety, increase revenue, and enhance the overall patient experience. Pharmaceutical manufacturer solutions help to improve healthcare through increased medication safety while also marketing products with innovative promotional solutions. RelayHealth Payor Services – Managing and simplifying interactions between providers and health plans RelayPayor products support the business of healthcare, which includes managing interactions between providers and financial partners to achieve operational goals. To support quality care improvements and reduced administrative costs across the healthcare industry, RelayHealth operates as a neutral partner in an open network environment, offering connectivity and interoperability among all organizations, systems and solutions. RelayPayor RelayHealth Payor Services

Transcript of RelayPayor overview

Page 1: RelayPayor overview

“We did not know how

we were going to create

5010 data for our testing.

TestTrack will be a great help

in preparing for 5010.”

– Regional Blues Plan

RelayHealth, McKesson’s connectivity business, offers real-time solutions to streamline interactions

throughout healthcare, connecting patients, providers, pharmacies, and payors. The net result:

improved care, faster access, lower costs and enhanced bottom lines.

RelayHealth

• Serves more than 2,000 hospitals, 200,000 physicians, and connects with more than 1,800 health

plans, and securely processes more than 12.8 billion financial and clinical transactions annually.

• Pioneered online communications with physicians and offers the most advanced practice

connectivity solutions available.

• Hospital solutions provide a secure, accessible infrastructure with the most evolved HIE

solution available.

• Pharmacy solutions support more than 90% of the nation’s pharmacies with customized solutions

that improve patient safety, increase revenue, and enhance the overall patient experience.

• Pharmaceutical manufacturer solutions help to improve healthcare through increased

medication safety while also marketing products with innovative promotional solutions.

RelayHealth Payor Services – Managing and simplifying interactions

between providers and health plans

RelayPayor products support the business of healthcare, which includes managing interactions

between providers and financial partners to achieve operational goals. To support quality care

improvements and reduced administrative costs across the healthcare industry, RelayHealth

operates as a neutral partner in an open network environment, offering connectivity and

interoperability among all organizations, systems and solutions.

RelayPayor™ RelayHealth Payor Services

Page 2: RelayPayor overview

Health Connections Brought to Life™

For more information, call (770) 237-7734, or send an inquiry to [email protected].

www.fasttrack5010.com

www.testtrack5010.com

RelayPayor

Payors continually seek opportunities to refine operations and create differentiation in a

competitive market. With enhanced connectivity to payors, members, and providers, RelayHealth

provides innovative solutions to enhance operations and increase market share.

RelayHealth – Leading the Industry with 5010 Solutions for Health Plans

www.fasttrack5010.com was developed to simplify the

changes required of payors for 5010, as well as facilitate testing.

FastTrack5010 provides educational resources to help prepare

payors for HIPAA 5010 development transition.

www.testtrack5010.com, an industry-leading online testing

tool and information resource, is available for pre-testing 5010

for payors. It helps payors simplify 5010 transactions, testing and

implementation, and performs gap analysis. It can help to reduce

development time by as much as 75%, and reduces the chance

of errors.

TestTrack5010 includes:

• Test data creation – Pull live claims to test current system gaps

• Connection utilities – Provides standardized connections that can be created directly from the

system

• Batch claim details – Permits review of transaction details after claims have been selected

• Real -time transaction – Allows real-time transaction exchanges for testing in a CORE Phase II

compliant system

Level 1 compliance deadline December 21, 2010 -- Providers can send test files to

RelayHealth PCS

Level 2 compliance deadline December 31, 2010 -- RelayHealth will begin end-to-end testing

with trading partners January 2011

ReLayHeaLTH PayoR SeRvIceS

PRovIDeS:

• EDI solutions and transactions processing

• Compliance with HIPAA 5010 and other

regulatory requirements

• Largest direct provider-to-payor network

• Tailored Payor Connectivity Services (PCS)

solution & seamless integration

• Hosting services

• Award winning customer service & best in

class support

• CORE Phase II certified

PayoR connecTIvITy SeRvIceS

(PcS) SoLuTIon IncLuDeS:

• PCS HIPAA-compliant Intelligent Gateway

• Scalable Software as a Service (SaaS)

platform

• Modular design which enables expansion of

applications and functionality

• Payor-customizable pre-adjudication

validation and routing

• Ability for submitters to correct claims prior

to submission

• 4010-to-5010 conversion service

• 5010 testing tool

• ICD-9 to ICD-10 compliance

• Payor and provider web reporting

• CORE Phase II certified