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TPA Modernize & Scale EDI 834

A3logics Assisted TPA Modernize & Scale EDI 834 Processing

About Client

Our client is a third-party benefits broker associated with more than 200 organizations spread across states of the US, offering a full array of administrative services that develops sustainable employee benefits for each employee. The client boasts to provide premium healthcare services to the associated companies that are designed to reduce the healthcare cost of the members of the organizations.

To meet the rapidly changing market with aggressive competition, our client was facing issues in providing customized and flexible solutions concerning the demand of the organization owners. A3logics assisted the TPA in developing a non-conventional, sustainable, and pliable solution, along with the necessary EDI consulting & staffing to integrate responsive & contemporary IT capabilities.

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Business Challenges

Accurate delivery of claim processing has always been an imperative task for our client, which encompasses the handling of issues such as variation in accumulator workflows, repricing, ghastly billing, and out-of-network providers.

Their earlier chosen off-shore solutions were neither cost-effective nor entertained automatic benefits processes. Other than these struggles, other challenges that our client faced while serving different companies with a full employer and employee benefits health and wellness plan space are -

The earlier third party system was unable to manage everyday aggressive challenges concerning onboarding new customers while serving existing accounts.

Some of the client's customers (employer of the organization) often switched plan designs and networks on a yearly basis adding overwhelming cyclical work.

Calculating and managing other employees' periods for further employee enrollment was an overburdening and inordinate task.

The full-service TPA also needed to focus on the pressing need for rapid integration and use of HIPAA EDI transaction sets for data quality assurance.

Our Solution

A3logics analysts realized the pain of managing all these workflows while continuing to deliver an optimized solution to align with the extensive market competition and risks thereby furnishing an excellent customer experience.

A3logics robust and flexible solution addressed the complexity and issues inherited in an EDI. They analyzed the need for the missing EDI standards - 834 & 837. These selections were made underlining long-term growth through extensive support for virtual new standards depending on the business requirements.

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Key Highlights of EDI Integrated Solution

Powerful Integration Solution by A3logics

AS2 Compatibility

A3logics EDI integrated solutions are equipped with AS2 method of transporting the data safely & reliably over the internet. This method encrypts the data in a form of an envelope that acts as an extensive layer of protection to avoid any leakage of data while transferring via MDN, message disposition notification.

Reporting

A3logics robust engineering solution for EDI comes with a reporting feature for all customers to monitor and analyze the disparity of all kinds of data - inbound & outbound. This feature is essential to make vital decisions for the business, improve data quality, access factual and accurate information while eliminating data entry errors. EDI-generated data can easily guide executives, customers, as well as employees with an accurate roadmap to success.

Onboarding

A scaling business requires much support of staffing solutions to onboard new employees seamlessly. A3logics onboarding service solutions allow the companies to connect with their partners with just a few clicks, using predefined templates. The instruction is clear and sorted for even a novice to understand and create new partners.

Mapping

A3logics delivers feature-rich and scalable EDI solutions. With the EDI mapping feature, the customers can leverage the data formatting and share to other business areas, such as ERP systems or accounting.

Security

The leading product engineering service provider, A3logics is a reliable resource for software capable of translating and transmitting data electronically. Additionally, security is a preliminary and fundamental part of any solution furnished by A3logics to its customers. Hence, ensuring communication of data between users in encrypted and secured networks.

ERP and Supply Chain Management

A3logics EDI solutions are flexible and comply with the necessary software such as Enterprise Resource Planning and Supply Chain Management (SCM). Users are leveraged to easily integrate A3logics EDI into existing software solutions eliminating the need for arduous and error-prone tasks, such as Mauna formatting and exchange of documents, preparing orders, invoices & more.

Improved Information Flow

A3logics motive behind crafting an EDI solution is to make improvements in the existing workflow. Their EDI integrated solution is enriched with modules and features to accommodate the flow, such as rule-based workflows, alerts & notifications, and EDI testing. These features are proven to enhance business efficiency as well as enable data standardization in the company and among associates.

Here are the Results/Numbers That Speak of EDI Integrated Services

  • 70% of the orders were automated

  • 10 days of work was achieved in 1 day

  • 80-90% B2B traffic is now conducted on EDI

  • 93% of users are satisfied with the improved performance

Tools & Technology

  • JSON

  • C

  • C++

  • Java

  • C#

  • Visual Basic

  • SQL

  • XML

  • ASCII files

  • EDIFACT

  • .NET

  • Cloud

TPA Benefits From A3logics EDI Integrated Solution

Leveraging the B2B EDI platform resulted in optimized financial and IT resources. The TPA was able to learn to improve as well as automate EDI 834 transactions with the help of staffing solutions provided by A3 logics. Additionally, the TPA was able to -

  • Common pitfalls with HIPAA EDI 834 and other EDI transactions.
  • Greater agility, faster project completion, speedy implementation, and overall reduced cost.
  • Automated and streamlined data exchange as a basis for benefits administration.
  • Internal databases, third-party vendors, and employee-facing portal interfacing with the employer's system was no issue anymore.
  • TPA was trained to work on EDI software to further meet the critical customer deliveries seamlessly.
  • Modernized, innovative solution for instant-problem solving for imperative growth.

Summary

A3logics is a reliable and leading EDI service provider assisting businesses to associate with their business partners easily. With the amalgamation of the right skill and knowledge, A3logics EDI analysts aim to dig deep into the loopholes of the customer to evaluate the best possible solution.

The dedicated and vigilant team of A3logics has the expertise to quickly accommodate the urgent requirements with a valuable solution that reduces the struggle to process unique needs while focusing on continuous business growth simultaneously.

If you are seeking an EDI expert for your problems, A3logics is always open for collaboration to assist you in achieving success. Whether you are new to this service or have trouble using the traditional EDI solutions, A3logics' wide range of services can solve all of them. EDI consulting aids in identifying and analyzing user pressing points and promotes support with easy-to-use tools and methodologies. So, if you are intending to know more about EDI and relatable services, drop us a line right away.